Ten year neurocognitive trajectories in first-episode psychosis

Erik Simonsen, Helene E. Barder, Kjetil Sundet, Bjørn R. Rund, Julie Evensen, Ulrik Haahr, Wenche Ten Velden Hegelstad, Inge Joa, Jan O. Johannessen, Johannes Langeveld, Tor K. Larsen, Ingrid Melle, Stein Opjordsmoen, Jan I. Rossberg, Per Vaglum, Thomas McGlashan, Svein Friis

    Research output: Contribution to journalJournal articlepeer-review

    Abstract

    Objective: Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP) and the relationship to clinically significant subgroups even more so. We report 10 year longitudinal neurocognitive development in a sample of FEP patients, and explore whether the trajectories of cognitive course are related to presence of relapse to psychosis, especially within the first year, with a focus on the course of verbal memory.

    Method: Forty-three FEP subjects (51% male, 28 +/- 9 years) were followed-up neurocognitively over five assessments spanning 10 years. The test battery was divided into four neurocognitive indices; Executive Function, Verbal Learning, Motor Speed, and Verbal Fluency. The sample was grouped into those relapsing or not within the first, second and fifth year.

    Results: The four neurocognitive indices showed overall stability over the 10 year period. Significant relapse by index interactions were found for all indices except Executive Function. Follow-up analyses identified a larger significant decrease over time for the encoding measure within Verbal Memory for patients with psychotic relapse in the first year[F-(4,F- (38)) = 5.8, p = 0.001, eta(2) = 0.40].

    Conclusions: Main findings are long-term stability in neurocognitive functioning in FEP patients, with the exception of verbal memory in patients with psychotic relapse or non-remission early in the course of illness. We conclude that worsening of specific parts of cognitive function may be expected for patients with on-going psychosis, but that the majority of patients do not show significant change in cognitive performance during the first 10 years after being diagnosed.
    Original languageEnglish
    Article number643
    JournalFrontiers in Human Neuroscience
    Volume7
    ISSN1662-5161
    DOIs
    Publication statusPublished - 2013

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