The relationship between level of cognitive impairments and functional outcome trajectories in first-episode schizophrenia

Abstract

Although cognitive impairments are consistently linked to functional outcome in chronic schizophrenia, the relationship remains unclear for patients with first-episode schizophrenia. The objective of this present study was to determine whether there are distinct developmental trajectories for functional outcome in patients with different levels of baseline cognition. The present study has a multi-follow-up design, and includes data from six follow-ups over four years. Assessments were conducted yearly, apart from the first year where assessments were conducted every six months. A total of 28 patients with first-episode schizophrenia participated in the study, with 79% of patients retained at the 4-year follow-up. Cognition was assessed with MATRICS Consensus Cognitive Battery. Functional outcomes were obtained through Global functioning: Social and Global functioning: Role. Data were analyzed with linear multilevel models. Results suggest steady improvements in social and role functioning among the patients across the four year period. Baseline attention, verbal learning, and verbal working memory were significantly associated with social outcome. Role functioning was significantly associated with attention, verbal working memory, and reasoning/problem solving. Furthermore, the rate of change in social outcome varies among patients depending on their baseline level of attention and verbal working memory, with the lowest scoring group showing the least improvement over the years. The subgroup of patients with the largest cognitive impairments at the onset of the disorder shows limited improvements in social functioning compared to higher functioning groups.

Impaired neuropsychological profile in homicide offenders with schizophrenia

“…Cognitive impairment is a defining feature of [6,7] and associated with functioning [8,9] in schizophrenia. Severe interpersonal violence, such as homicide, is an example of very poor functional outcome.…”

Neurocognitive differences between inpatients and outpatients with symptomatically nonremitted schizophrenia: A cross-sectional study

“…A longitudinal association between working memory at baseline and social function 13 years later has also been observed . Additionally, Czajkowski et al . conducted a 4‐year longitudinal study and reported that social function in patients with worse working memory performance at baseline did not improve across the 4 years.…”

Do clinical characteristics predict the cognitive course in early‐onset schizophrenia‐spectrum disorders?

“…The incidence of EOS is very low, and we included all potential participants in Norway over a period of 4 years and arrived at a group size that complies with other EOS studies (Frangou et al, 2008;Jepsen, Fagerlund, Pagsberg, Christensen, Hilker, et al, 2010;Oie & Rund, 1999), with a similar attrition rate Kravariti et al, 2003a,b;Wozniak et al, 2008). Also, the sample size matches comparable EOS and first episode schizophrenia studies using the same neuropsychological test battery (Fu, Czajkowski, Rund, & Torgalsboen, 2017;Holmen et al, 2010). Furthermore, the drop-out of patients and missing data represent a limitation.…”