Cognitive Deficits in First Episode Schizophrenia

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
S. Galderisi
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Cognitive Abilities ◽  
Psychotic Disorders ◽  
Treatment Strategies ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Baseline Evaluation ◽  
Z Scores ◽  
First Episode Schizophrenia

Cognitive deficits are increasingly recognized as key features of schizophrenia, important determinants of poor psychosocial outcome and targets for treatment strategies. The huge literature on the topic made it clear that cognitive impairment is present in the majority of subjects with schizophrenia, is not an epiphenomenon of symptoms, is a risk factor for psychotic disorders and seems to contribute to poor functional outcome more than symptoms. However, relationships of cognitive impairment with symptoms, drug treatment and duration of untreated psychosis remain controversial and studies involving large cohorts of first episode schizophrenia patients are highly needed to address these topics adequately. The European First Episode Schizophrenia Trial collected demographic, clinical, psychosocial and cognitive baseline data in 498 first episode patients with schizophrenia, schizophreniform or schizoaffective disorder, with minimal or no prior exposure to antipsychotics, and in 220 healthy subjects, comparable with patients for age, sex, race and education level of parents. Z scores of the examined cognitive abilities (number of standard deviations below the comparison group means) ranged from -0.88 to -1.73. No association was found between the duration of untreated psychosis and cognitive impairment. Psychopathological dimensions were weakly correlated with cognitive impairment both at baseline evaluation and after six months of treatment.According to EUFEST findings, cognitive impairment in patients with first-episode schizophrenia is moderate/severe, has no association with the duration of untreated psychosis, involves several domains of cognition, and is largely independent from psychopathology.

Research and treatment strategies in first-episode psychoses: The Pittsburgh experience

1998 ◽  
Vol 172 (S33) ◽  
pp. 60-65 ◽  
Author(s):  
M. S. Keshavan ◽  
N. R. Schooler ◽  
J. A. Sweeney ◽  
G. L. Haas ◽  
J. W. Pettegrew
Keyword(s):  
Psychotic Disorders ◽  
Treatment Strategies ◽  
First Episode ◽  
Resonance Imaging ◽  
Neurodevelopmental Model ◽  
First Choice ◽  
Imaging And Spectroscopy ◽  
Spectroscopy Studies ◽  
First Episode Schizophrenia ◽  
The Impact

Background Studies of first-episode patients allow investigation of the biological basis of psychotic disorders without the potential confounds of prior treatment and illness chronicity. Prospective studies of this population can clarify the impact of illness course and treatment on neurobiology.Method We summarise preliminary findings from our ongoing magnetic resonance imaging and spectroscopy studies of first-episode schizophrenia patients being conducted prospectively from index evaluations through a period of two years; during this period, patients were treated with either a conventional antipsychotic such as haloperidol, or the atypical risperidone.Results Baseline neurobiological evaluations in first-episode schizophrenia patients have revealed evidence for structural and functional brain abnormalities consistent with a neurodevelopmental model of this illness. Our preliminary data support the value of risperidone as an antipsychotic drug of first choice among patients with early schizophrenic illness.Conclusions Focused studies of first-episode patients have the potential to unravel pathophysiology of schizophrenic illness. Such knowledge is critical for more effective early detection, intervention and even prevention of this enigmatic disorder.

scholarly journals M68. COGNITIVE IMPAIRMENT IN NEVER-TREATED SCHIZOPHRENIA SPECTRUM INDIVIDUALS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S161-S161
Author(s):  
Rodolfo Solis-Vivanco ◽  
Felipe Rangel-Hassey ◽  
Pablo León-Ortiz ◽  
Alejandra Mondragón-Maya ◽  
Francisco Reyes-Madrigal ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Visual Learning ◽  
Cognitive Domain ◽  
First Episode ◽  
Control Group ◽  
Duration Of Untreated Psychosis ◽  
Schizophrenia Spectrum ◽  
Main Effect ◽  
Patient Groups

Abstract Background Cognitive impairment is a key feature of schizophrenia. While one recent study suggested that individuals with psychosis experience a progressive decline in certain cognitive domains during the first 10 years of their illness, other clinical and functional MRI-based studies have proposed that most cognitive deficits are present during the first episode and remain stable over time, possibly as a result of medication response. To examine the temporal nature of cognitive deficits in the schizophrenia spectrum, we examined cognition in never-medicated individuals at different stages of the illness. Methods We recruited three groups of patients: 1) individuals at clinical high-risk (CHR) for psychosis (n=87), 2) individuals experiencing their first-episode of a non-affective psychosis (FEP) (n=64) (defined by a duration of untreated psychosis < 74 weeks), and 3) individuals with chronic schizophrenia (n=40) (CSz – duration of untreated psychosis > 74 weeks). All three groups were antipsychotic-naïve. Patients with any comorbid disorders or current substance abuse disorders were excluded from this study. We also recruited matched healthy control subjects (n=102). All subjects were recruited at the Instituto Nacional de Neurología y Neurocirugía in Mexico City. The study was approved by the institutional review board. Adults provided written informed consent and minors provided assent with written consent provided by both parents. Cognition was assessed with the MATRICS Consensus Cognitive Battery. Differences between groups were analyzed using a repeated measures analysis of variance (RM-ANOVA) with cognitive domain as inter-subject factor and Bonferroni correction for post hoc pairwise comparisons. Statistical significance was set at p ≤ .05. Results Since age, gender, and parental education were significantly different between the groups, they were included as covariates in the RM-ANOVA. In this revised model, there was no main effect of age (p = 0.69) nor any interaction between age and any cognitive domain. Therefore, age was removed from the final model. We observed a significant main effect of group (p <.001); All patient groups were significantly impaired compared to the control group (CHR mean difference (MD) = 6.12; FEP MD = 16.46; CSz MD = 16.37; p <.001 in all cases), individuals with both FEP and CSz had significantly more cognitive impairment than the CHR group (FEP MD = 10.34; CSz MD = 10.25; p <.001 in both cases). No significant differences were observed between FEP and CSz groups (MD = .09, p >.99). We also found a significant group by cognitive domain interaction (p <.001). Namely, all patient groups were cognitively impaired compared to the control group, except in the Verbal and Visual Learning domains in which there were no significant differences between the control and CHR groups. No significant differences were found between the FEP and CSz groups in any domain. Moreover, the CHR group was not significantly different from the other clinical groups in the Social Cognition domain. Within the FEP and CSz groups, no significant correlations were observed between duration of untreated psychosis and any cognitive domain. Discussion We observed significant cognitive deficits since at-risk stages of the schizophrenia spectrum. Patients with FEP were as impaired as those with CSz, while cognitive functioning observed in CHR individuals was intermediate between controls and patients with syndromal psychosis. These results emphasize the importance of pre-syndromal detection and prediction of burgeoning psychotic illness. Future research on strategies to mitigate the decline in cognitive function between presyndromal and first-episode psychosis is warranted.

Cortical morphometric correlational networks associated with cognitive deficits in first episode schizophrenia

2021 ◽  
Vol 231 ◽  
pp. 179-188
Author(s):  
Chencai Wang ◽  
Talia Oughourlian ◽  
Todd A. Tishler ◽  
Faizan Anwar ◽  
Catalina Raymond ◽  
...  
Keyword(s):  
Cognitive Deficits ◽  
First Episode ◽  
First Episode Schizophrenia

Cognitive deficits and its relation with psychopathology and global functioning in first episode schizophrenia

2013 ◽  
Vol 6 (6) ◽  
pp. 537-543 ◽  
Author(s):  
Shantala Hegde ◽  
Jagadhisha Thirthalli ◽  
Shobini L. Rao ◽  
Ahalya Raguram ◽  
Mariamma Philip ◽  
...  
Keyword(s):  
Cognitive Deficits ◽  
First Episode ◽  
Global Functioning ◽  
First Episode Schizophrenia

scholarly journals Duration of untreated psychosis of first-episode psychotic disorders in Yogyakarta, Indonesia

2019 ◽  
Vol 7 (2) ◽  
pp. 61-64
Author(s):  
Carla R. Marchira ◽  
Irwan Supriyanto
Keyword(s):  
Psychotic Disorders ◽  
Rating Scale ◽  
First Episode ◽  
Medical Facility ◽  
Duration Of Untreated Psychosis ◽  
Global Assessment Of Functioning ◽  
Global Functioning ◽  
Syndrome Scale ◽  
Negative Syndrome ◽  
Gaf Scores

Introduction: Duration of untreated psychosis (DUP) is an important predictor for prognosis in first episode of psychotic disorders. Caregivers often seek help from alternative healers first and health professional later. These would delay proper treatments for the patients, resulting in more severe symptoms and lower functioning on their visit to medical facility. The present study aims to find the association between DUP, symptoms severity, and global functioning in patients with first-episode psychotic disorders. Methods: We identified 100 patients with first episode of psychotic disorders and their caregivers. The instruments used were Brief Psychotic Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Premorbid Schizoid-Schizotypal Traits (PSST), and Global Assessment of Functioning (GAF). Results: There were no significant association between BPRS, PANSS, PSST, and GAF scores and DUP in our subjects. Nevertheless, we found that men had significantly longer DUP compared to women. Conclusion: We found significant association between sex and DUP in this study. Longer DUP leads to delayed treatments and poorer prognosis. Further study is required to confirm our finding.

Symptomatic Remission and Cognitive Impairment in First-Episode Schizophrenia

2013 ◽  
Vol 74 (11) ◽  
pp. e1046-e1053 ◽  
Author(s):  
Wing Chung Chang ◽  
Christy Lai Ming Hui ◽  
Gloria Hoi Yan Wong ◽  
Sherry Kit Wa Chan ◽  
Edwin Ho Ming Lee ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
First Episode ◽  
Symptomatic Remission ◽  
First Episode Schizophrenia

scholarly journals Cognitive deficits and white matter abnormalities in never-treated first-episode schizophrenia

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mi Yang ◽  
Shan Gao ◽  
Xiangyang Zhang
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Diffusion Tensor ◽  
Internal Capsule ◽  
First Episode ◽  
Control Group ◽  
Pathophysiological Mechanism ◽  
Healthy Controls ◽  
Healthy Control ◽  
First Episode Schizophrenia

Abstract Cognitive impairment is viewed as a core symptom of schizophrenia (SCZ), but its pathophysiological mechanism remains unclear. White matter (WM) disruption is considered to be a central abnormality that may contribute to cognitive impairment in SCZ patients. However, few studies have addressed the association between cognition and WM integrity in never-treated first-episode (NTFE) patients with SCZ. In this study, we used the MATRICS Consensus Cognitive Battery (MCCB) to evaluate cognitive function in NTFE patients (n = 39) and healthy controls (n = 30), and associated it with whole-brain fractional anisotropy (FA) values obtained via voxel-based diffusion tensor imaging. We found that FA was lower in five brain areas of SCZ patients, including the cingulate gyrus, internal capsule, corpus callosum, cerebellum, and brainstem. Compared with the healthy control group, the MCCB’s total score and 8 out of 10 subscores were significantly lower in NTFE patients (all p < 0.001). Moreover, in patients but not healthy controls, the performance in the Trail Making Test was negatively correlated with the FA value in the left cingulate. Our findings provide evidence that WM disconnection is involved in some cognitive impairment in the early course of SCZ.

Sign in / Sign up

Export Citation Format

Share Document