1
|
Slot MIE, van Hell HH, Rossum IWV, Dazzan P, Maat A, de Haan L, Crespo-Facorro B, Glenthøj B, Lawrie SM, McDonald C, Gruber O, van Amelsvoort T, Arango C, Kircher T, Nelson B, Galderisi S, Weiser M, Sachs G, Maatz A, Bressan RA, Kwon JS, Mizrahi R, McGuire P, Kahn RS. A naturalistic cohort study of first-episode schizophrenia spectrum disorder: A description of the early phase of illness in the PSYSCAN cohort. Schizophr Res 2024; 266:237-248. [PMID: 38431986 DOI: 10.1016/j.schres.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 07/18/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND We examined the course of illness over a 12-month period in a large, international multi-center cohort of people with a first-episode schizophrenia spectrum disorder (FES) in a naturalistic, prospective study (PSYSCAN). METHOD Patients with a first episode of schizophrenia, schizoaffective disorder (depressive type) or schizophreniform disorder were recruited at 16 institutions in Europe, Israel and Australia. Participants (N = 304) received clinical treatment as usual throughout the study. RESULTS The mean age of the cohort was 24.3 years (SD = 5.6), and 67 % were male. At baseline, participants presented with a range of intensities of psychotic symptoms, 80 % were taking antipsychotic medication, 68 % were receiving psychological treatment, with 46.5 % in symptomatic remission. The mean duration of untreated psychosis was 6.2 months (SD = 17.0). After one year, 67 % were in symptomatic remission and 61 % were in functional remission, but 31 % had been readmitted to hospital at some time after baseline. In the cohort as a whole, depressive symptoms remained stable over the follow-up period. In patients with a current depressive episode at baseline, depressive symptoms slightly improved. Alcohol, tobacco and cannabis were the most commonly used substances, with daily users of cannabis ranging between 9 and 11 % throughout the follow-up period. CONCLUSIONS This study provides valuable insight into the early course of a broad range of clinical and functional aspects of illness in FES patients in routine clinical practice.
Collapse
Affiliation(s)
- Margot I E Slot
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
| | - Hendrika H van Hell
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
| | - Inge Winter-van Rossum
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Department of Psychiatry and Behavioral Health System, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029-6574, United States of America.
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark 458 Hill, London SE5 8AF, United Kingdom.
| | - Arija Maat
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
| | - Lieuwe de Haan
- Amsterdam UMC, University of Amsterdam, Psychiatry, Department Early Psychosis, Meibergdreef 9, Amsterdam, the Netherlands.
| | - Benedicto Crespo-Facorro
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain; Department of Psychiatry, University of Sevilla. Hospital Universitario Virgen del Rocio, IBiS-CSIC, Sevilla, Spain.
| | - Birte Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Dept. of Clinical Medicine, Copenhagen, Denmark.
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom.
| | - Colm McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland.
| | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany.
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; Mondriaan Mental Health Centre, Maastricht, the Netherlands.
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Centro de Investigación Biomédica en Red del área de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Tilo Kircher
- Department of Psychiatry, University of Marburg, Rudolf-Bultmann-Straße 8, D-35039 Marburg, Germany.
| | - Barnaby Nelson
- Orygen, 35 Poplar Road, Parkville, Victoria, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
| | - Silvana Galderisi
- University of Campania Luigi Vanvitelli, Largo Madonna delle Grazie, 80138 Naples, Italy
| | - Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer 52621, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria.
| | - Anke Maatz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
| | - Rodrigo A Bressan
- Department of Psychiatry, Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, 101 Dahakno, Jongno-gu, Seoul, Republic of Korea.
| | - Romina Mizrahi
- Department of Psychiatry, McGill University, Montreal, Canada.
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
| | - René S Kahn
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Department of Psychiatry and Behavioral Health System, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029-6574, United States of America.
| |
Collapse
|
2
|
Catalan A, Richter A, Salazar de Pablo G, Vaquerizo-Serrano J, Mancebo G, Pedruzo B, Aymerich C, Solmi M, González-Torres MÁ, Gil P, McGuire P, Fusar-Poli P. Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis. Eur Psychiatry 2021; 64:e69. [PMID: 34730080 PMCID: PMC8668449 DOI: 10.1192/j.eurpsy.2021.2246] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background To determine the proportion of patients in symptomatic remission and recovery following a first-episode of psychosis (FEP). Methods A multistep literature search using the Web of Science database, Cochrane Central Register of Reviews, Ovid/PsychINFO, and trial registries from database inception to November 5, 2020, was performed. Cohort studies and randomized control trials (RCT) investigating the proportion of remission and recovery following a FEP were included. Two independent researchers searched, following PRISMA and MOOSE guidelines and using a PROSPERO protocol. We performed meta-analyses regarding the proportion of remission/recovery (symptomatic plus functional outcomes). Heterogeneity was measured employing Q statistics and I2 test. To identify potential predictors, meta-regression analyses were conducted, as well as qualitative reporting of studies included in a systematic review. Sensitivity analyses were performed regarding different times of follow-up and type of studies. Results One hundred articles (82 cohorts and 18 RCTs) were included in the meta-analysis. The pooled proportion of symptomatic remission was 54% (95%CI [30, 49–58]) over a mean follow-up period of 43.57 months (SD = 51.82) in 76 studies. After excluding RCT from the sample, the proportion of remission remained similar (55%). The pooled proportion of recovery was 32% (95%CI [27–36]) over a mean follow-up period of 71.85 months (SD = 73.54) in 40 studies. After excluding RCT from the sample, the recovery proportion remained the same. No significant effect of any sociodemographic or clinical predictor was found. Conclusions Half of the patients are in symptomatic remission around 4 years after the FEP, while about a third show recovery after 5.5 years.
Collapse
Affiliation(s)
- Ana Catalan
- Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Barakaldo, Spain.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Anja Richter
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain.,Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Julio Vaquerizo-Serrano
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Gonzalo Mancebo
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Borja Pedruzo
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Claudia Aymerich
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Department of Psychiatry, University of Ottawa, Ontario, Canada.,Department of Mental Health, The Ottawa Hospital, Ontario, Canada.,Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, Ontario
| | - Miguel Á González-Torres
- Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Barakaldo, Spain
| | - Patxi Gil
- Mental Health Department, Biocruces Bizkaia Health Research Institute, Early Intervention Service, Bizkaia Mental Health System, Bilbao, Spain
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
3
|
Kilciksiz CM, Keefe R, Benoit J, Öngür D, Torous J. Verbal memory measurement towards digital perspectives in first-episode psychosis: A review. Schizophr Res Cogn 2020; 21:100177. [PMID: 32322540 PMCID: PMC7163058 DOI: 10.1016/j.scog.2020.100177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/20/2020] [Accepted: 03/21/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Even in the early phases of psychotic spectrum illnesses such as schizophrenia, patients can experience cognitive decline or deficits prior to the onset of psychotic symptoms such as delusions and hallucinations. In this systematic review, we assessed which verbal memory assessments are most widely used in first-episode psychosis and may be applied via digital technologies (smartphone applications, etc.) for use in early detection. METHODS In November 2019, we searched for studies measuring verbal memory in first episode psychosis or schizophrenia over the past 10 years on PubMed and PsycINFO. We screened abstracts of these studies and excluded review studies. Full-texts of included studies were used to identify the verbal memory measurement tests, follow-up frequencies, and sample sizes. RESULTS We screened 233 reports and found that 120 original research studies measured verbal memory in first episode psychosis over the past 10 years. Four of these studies specified using a computer, 24 (20%) used a paper-pen format, 1(1%) used both, and 91 (76%) studies did not specify their administration tools or suggest there were offered in digital formats. Thirty-five (30%) studies had follow-up measurements of verbal memory, while 85 (70%) had only a single verbal memory measurement. DISCUSSION While many scales are commonly used to measure verbal memory in first episode psychosis, they are not often administered via digital technology. There is an emerging opportunity to administer these and other tests via digital technologies for expanding access to early detection of cognitive decline in clinical high risk and first-episode psychosis.
Collapse
Affiliation(s)
- Can Mişel Kilciksiz
- Digital Psychiatry Division, Psychosis Research Program, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| | - Richard Keefe
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States of America
| | - James Benoit
- Digital Psychiatry Division, Psychosis Research Program, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| | - Dost Öngür
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States of America
| | - John Torous
- Digital Psychiatry Division, Psychosis Research Program, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| |
Collapse
|
4
|
Allott K, Wood SJ, Yuen HP, Yung AR, Nelson B, Brewer WJ, Spiliotacopoulos D, Bruxner A, Simmons M, Broussard C, Mallawaarachchi S, Pantelis C, McGorry PD, Lin A. Longitudinal Cognitive Performance in Individuals at Ultrahigh Risk for Psychosis: A 10-year Follow-up. Schizophr Bull 2019; 45:1101-1111. [PMID: 30321434 PMCID: PMC6737482 DOI: 10.1093/schbul/sby143] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
It remains unclear whether the onset of psychosis is associated with deterioration in cognitive performance. The aim of this study was to examine the course of cognitive performance in an ultrahigh risk (UHR) cohort, and whether change in cognition is associated with transition to psychosis and change in functioning. Consecutive admissions to Personal Assessment and Crisis Evaluation (PACE) Clinic between May 1994 and July 2000 who had completed a comprehensive cognitive assessment at baseline and follow-up were eligible (N = 80). Follow-up ranged from 7.3 to 13.4 years (M = 10.4 years; SD = 1.5). In the whole sample, significant improvements were observed on the Similarities (P = .03), Information (P < .01), Digit Symbol Coding (P < .01), and Trail Making Test-B (P = .01) tasks, whereas performance on the Rey Auditory Verbal Learning Test (Trials 1-3) declined significantly (P < .01) over the follow-up period. Change in performance on cognitive measures was not significantly associated with transition status. Taking time to transition into account, those who transitioned after 1 year showed significant decline on Digit Symbol Coding, whereas those who did not transition improved on this measure (P = .01; effect size [ES] = 0.85). Small positive correlations were observed between improvements in functioning and improvements in performance on Digit Symbol Coding and Arithmetic (0.24, P = .03 and 0.28, P = .01, respectively). In summary, the onset of psychosis was not associated with deterioration in cognitive ability. However, specific findings suggest that immediate verbal learning and memory, and processing speed may be relevant domains for future risk models and early intervention research in UHR individuals.
Collapse
Affiliation(s)
- Kelly Allott
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia,To whom correspondence should be addressed; The National Centre of Excellence in Youth Mental Health, Parkville, VIC 3052, Australia; tel: +61 3 9342 2858, fax: +61 3 9342 2941, e-mail:
| | - Stephen J Wood
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia,School of Psychology, University of Birmingham, Birmingham, UK
| | - Hok Pan Yuen
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Alison R Yung
- Division of Psychology and Mental Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Warrick J Brewer
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Daniela Spiliotacopoulos
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Annie Bruxner
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Magenta Simmons
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Christina Broussard
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Sumudu Mallawaarachchi
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Parkville, Victoria, Australia
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| |
Collapse
|
5
|
Jordan G, Veru F, Lepage M, Joober R, Malla A, Iyer SN. Pathways to functional outcomes following a first episode of psychosis: The roles of premorbid adjustment, verbal memory and symptom remission. Aust N Z J Psychiatry 2018; 52:793-803. [PMID: 29250962 DOI: 10.1177/0004867417747401] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Most studies have investigated either the singular or relative contributions of premorbid adjustment, verbal memory and symptom remission to functional outcomes in first-episode psychosis. Fewer studies have examined the pathways of these factors in impacting functioning. Our study addresses this gap. The objective was to determine whether the relationship between premorbid adjustment and functional outcomes was mediated by verbal memory and symptom remission. METHOD A total of 334 first-episode psychosis participants (aged 14-35 years) were assessed on premorbid adjustment, verbal memory upon entry, and positive and negative symptom remission and functioning at multiple time points over a 2-year follow-up. RESULTS Mediation analyses showed that over the first year, the relationship between premorbid adjustment and functioning was mediated by verbal memory and positive symptom remission (β = -0.18; 95% confidence interval = [-0.51, -0.04]), as well as by verbal memory and negative symptom remission (β = -0.41; 95% confidence interval = [-1.11, -1.03]). Over 2 years, the relationship between premorbid adjustment and functioning was mediated by verbal memory and only negative symptom remission (β = -0.38; 95% confidence interval = [-1.46, -0.02]). CONCLUSION Comparatively less malleable factors (premorbid adjustment and verbal memory) may contribute to functional outcomes through more malleable factors (symptoms). Promoting remission may be an important parsimonious means to achieving better functional outcomes.
Collapse
Affiliation(s)
- Gerald Jordan
- 1 Department of Psychiatry, McGill University, Montreal, QC, Canada.,2 Douglas Mental Health University Institute, Montreal, QC, Canada.,3 Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Montreal, QC, Canada.,4 ACCESS Open Minds, Strategy for Patient-Oriented Research, Canadian Institutes of Health Research, Montreal, QC, Canada
| | - Franz Veru
- 1 Department of Psychiatry, McGill University, Montreal, QC, Canada.,2 Douglas Mental Health University Institute, Montreal, QC, Canada.,3 Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Montreal, QC, Canada
| | - Martin Lepage
- 1 Department of Psychiatry, McGill University, Montreal, QC, Canada.,2 Douglas Mental Health University Institute, Montreal, QC, Canada.,3 Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Montreal, QC, Canada
| | - Ridha Joober
- 1 Department of Psychiatry, McGill University, Montreal, QC, Canada.,2 Douglas Mental Health University Institute, Montreal, QC, Canada.,3 Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Montreal, QC, Canada.,4 ACCESS Open Minds, Strategy for Patient-Oriented Research, Canadian Institutes of Health Research, Montreal, QC, Canada
| | - Ashok Malla
- 1 Department of Psychiatry, McGill University, Montreal, QC, Canada.,2 Douglas Mental Health University Institute, Montreal, QC, Canada.,3 Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Montreal, QC, Canada.,4 ACCESS Open Minds, Strategy for Patient-Oriented Research, Canadian Institutes of Health Research, Montreal, QC, Canada
| | - Srividya N Iyer
- 1 Department of Psychiatry, McGill University, Montreal, QC, Canada.,2 Douglas Mental Health University Institute, Montreal, QC, Canada.,3 Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Montreal, QC, Canada.,4 ACCESS Open Minds, Strategy for Patient-Oriented Research, Canadian Institutes of Health Research, Montreal, QC, Canada
| |
Collapse
|
6
|
Demmo C, Lagerberg TV, Kvitland LR, Aminoff SR, Hellvin T, Simonsen C, Haatveit B, Andreassen OA, Melle I, Ueland T. Neurocognitive functioning, clinical course and functional outcome in first-treatment bipolar I disorder patients with and without clinical relapse: A 1-year follow-up study. Bipolar Disord 2018; 20:228-237. [PMID: 29121444 DOI: 10.1111/bdi.12569] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 08/21/2017] [Accepted: 09/22/2017] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Due to limited research on the association between recurrence of mood episodes and the longitudinal course of neurocognitive functioning in early phase bipolar I disorder (BD I), the impact of recurrence on neurocognition remains unclear. Further, a strong correlation between neurocognitive impairment and functional impairment has been demonstrated. The longitudinal relationship between neurocognitive impairment and functional outcome in relation to recurrence is, however, not established. METHODS The current study investigated the longitudinal relationship between neurocognition, recurrence of mood episodes and functional outcome in a sample of first-treatment (FT) BD I patients (N = 42), with and without relapse, during a 1-year follow-up period. The longitudinal course of neurocognitive functioning in the patients was also compared to that of a group of healthy controls (N = 143). RESULTS Compared to both patients with relapse and healthy controls, no-relapse patients showed neurocognitive improvements. The polarity of the relapse episodes was mostly depressive, and for the no-relapse patients, reduction of symptoms was associated with neurocognitive improvement. No-relapse patients showed better global and occupational functioning. CONCLUSIONS The current study found different neurocognitive and functional trajectories in FT BD I patients with and without relapse, with differences at follow-up to some degree being mediated by current symptoms. The current findings highlight the importance of treatment focusing on neurocognition and symptom states with the aim of improving functional recovery.
Collapse
Affiliation(s)
- Christine Demmo
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Trine V Lagerberg
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Levi R Kvitland
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sofie R Aminoff
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Specialized Inpatient Treatment, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Tone Hellvin
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carmen Simonsen
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Beathe Haatveit
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torill Ueland
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| |
Collapse
|
7
|
Allott KA, Yuen HP, Bartholomeusz CF, Rapado-Castro M, Phassouliotis C, Butselaar F, Wood SJ, Proffitt TM, Savage G, Phillips LJ, Bendall S, Markulev C, Reniers RLEP, Pantelis C, Baldwin L, McGorry PD, Garner B. Stress hormones and verbal memory in young people over the first 12 weeks of treatment for psychosis. Psychiatry Res 2018; 260:60-66. [PMID: 29175500 DOI: 10.1016/j.psychres.2017.11.044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 11/15/2017] [Accepted: 11/16/2017] [Indexed: 12/24/2022]
Abstract
AIMS Memory impairment in psychosis may be mediated through detrimental effects of hypothalamic-pituitary-adrenal (HPA) axis function. This study prospectively investigated the relationship between cortisol, sulphate dehydroepiandrosterone (DHEA(S) and cortisol: DHEA(S) ratio and memory in 35 first-episode psychosis (FEP) patients during the first 12 weeks of treatment and 23 healthy controls (HC). METHODS Morning blood sampling and tests of attention, working memory and verbal memory occurred at baseline and 12-week follow-up. RESULTS FEP and HC groups did not significantly differ in levels of cortisol, DHEA(S) or their ratio at baseline or over 12-weeks. The FEP group performed significantly below HC on all cognitive measures at baseline and over 12-weeks. Cortisol levels were unrelated to cognition in both groups. At baseline, DHEA(S) was positively associated with attention in HCs, but negatively associated with attention in FEP participants. Change in DHEA(S) was negatively associated with change in memory over 12-weeks in both groups. At 12-weeks, there was a negative correlation between the cortisol: DHEA(S) ratio and attention in both groups. CONCLUSIONS These findings are mostly in contrast to findings in chronic schizophrenia. Investigation at different illness phases and over longer-follow-up periods is required to determine the complex relationship between HPA-axis and memory functioning in psychosis.
Collapse
Affiliation(s)
- Kelly A Allott
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.
| | - Hok Pan Yuen
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Cali F Bartholomeusz
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; Melbourne Neuropsychiatry Centre, The University of Melbourne, Parkville, Australia
| | - Marta Rapado-Castro
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Parkville, Australia; Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, CIBERSAM, Madrid, Spain
| | | | - Felicity Butselaar
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Stephen J Wood
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; School of Psychology and Institute of Clinical Sciences, University of Birmingham, United Kingdom
| | - Tina-Marie Proffitt
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Greg Savage
- ARC Centre of Excellence in Cognition and its Disorders, Department of Psychology, Macquarie University, Sydney, Australia
| | - Lisa J Phillips
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Sarah Bendall
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Connie Markulev
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Renate L E P Reniers
- School of Psychology and Institute of Clinical Sciences, University of Birmingham, United Kingdom
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Parkville, Australia
| | - Lara Baldwin
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Belinda Garner
- Translational Research Institute, Institute of Health and Biomedical Innovation, School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Queensland, Australia
| |
Collapse
|
8
|
Lally J, Ajnakina O, Stubbs B, Cullinane M, Murphy KC, Gaughran F, Murray RM. Remission and recovery from first-episode psychosis in adults: systematic review and meta-analysis of long-term outcome studies. Br J Psychiatry 2017; 211:350-358. [PMID: 28982659 DOI: 10.1192/bjp.bp.117.201475] [Citation(s) in RCA: 221] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/06/2017] [Accepted: 06/10/2017] [Indexed: 01/17/2023]
Abstract
BackgroundRemission and recovery rates for people with first-episode psychosis (FEP) remain uncertain.AimsTo assess pooled prevalence rates of remission and recovery in FEP and to investigate potential moderators.MethodWe conducted a systematic review and meta-analysis to assess pooled prevalence rates of remission and recovery in FEP in longitudinal studies with more than 1 year of follow-up data, and conducted meta-regression analyses to investigate potential moderators.ResultsSeventy-nine studies were included representing 19072 patients with FEP. The pooled rate of remission among 12301 individuals with FEP was 58% (60 studies, mean follow-up 5.5 years). Higher remission rates were moderated by studies from more recent years. The pooled prevalence of recovery among 9642 individuals with FEP was 38% (35 studies, mean follow-up 7.2 years). Recovery rates were higher in North America than in other regions.ConclusionsRemission and recovery rates in FEP may be more favourable than previously thought. We observed stability of recovery rates after the first 2 years, suggesting that a progressive deteriorating course of illness is not typical. Although remission rates have improved over time recovery rates have not, raising questions about the effectiveness of services in achieving improved recovery.
Collapse
Affiliation(s)
- John Lally
- John Lally, MB MSc MRCPsych, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK, and Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland, and Department of Psychiatry, School of Medicine and Medical Sciences, University College Dublin, St Vincent's University Hospital, Dublin, Ireland; Olesya Ajnakina, MSc PhD, Department of Psychosis Studies, IoPPN, King's College London, London, UK; Brendon Stubbs, MSc MCSP PhD, Health Service and Population Research Department, IoPPN, King's College London, and Physiotherapy Department, South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK; Michael Cullinane, MB MRCPsych, Young Adult Mental Health Services, St Fintan's Hospital, Portlaoise, Ireland; Kieran C. Murphy, MMedSci PhD FRCPI FRCPsych, Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Fiona Gaughran, MD FRCPI FRCP FRCPsych, National Psychosis Service, South London and Maudsley NHS Foundation Trust, IoPPN, Kings College London, and Collaboration for Leadership in Applied Health Research and Care, South London Psychosis Research Team, London, UK; Robin M. Murray, MD DSc FRCP FRCPsych FMedSci FRS, IoPPN, King's College London, and National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Olesya Ajnakina
- John Lally, MB MSc MRCPsych, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK, and Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland, and Department of Psychiatry, School of Medicine and Medical Sciences, University College Dublin, St Vincent's University Hospital, Dublin, Ireland; Olesya Ajnakina, MSc PhD, Department of Psychosis Studies, IoPPN, King's College London, London, UK; Brendon Stubbs, MSc MCSP PhD, Health Service and Population Research Department, IoPPN, King's College London, and Physiotherapy Department, South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK; Michael Cullinane, MB MRCPsych, Young Adult Mental Health Services, St Fintan's Hospital, Portlaoise, Ireland; Kieran C. Murphy, MMedSci PhD FRCPI FRCPsych, Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Fiona Gaughran, MD FRCPI FRCP FRCPsych, National Psychosis Service, South London and Maudsley NHS Foundation Trust, IoPPN, Kings College London, and Collaboration for Leadership in Applied Health Research and Care, South London Psychosis Research Team, London, UK; Robin M. Murray, MD DSc FRCP FRCPsych FMedSci FRS, IoPPN, King's College London, and National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Brendon Stubbs
- John Lally, MB MSc MRCPsych, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK, and Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland, and Department of Psychiatry, School of Medicine and Medical Sciences, University College Dublin, St Vincent's University Hospital, Dublin, Ireland; Olesya Ajnakina, MSc PhD, Department of Psychosis Studies, IoPPN, King's College London, London, UK; Brendon Stubbs, MSc MCSP PhD, Health Service and Population Research Department, IoPPN, King's College London, and Physiotherapy Department, South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK; Michael Cullinane, MB MRCPsych, Young Adult Mental Health Services, St Fintan's Hospital, Portlaoise, Ireland; Kieran C. Murphy, MMedSci PhD FRCPI FRCPsych, Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Fiona Gaughran, MD FRCPI FRCP FRCPsych, National Psychosis Service, South London and Maudsley NHS Foundation Trust, IoPPN, Kings College London, and Collaboration for Leadership in Applied Health Research and Care, South London Psychosis Research Team, London, UK; Robin M. Murray, MD DSc FRCP FRCPsych FMedSci FRS, IoPPN, King's College London, and National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Michael Cullinane
- John Lally, MB MSc MRCPsych, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK, and Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland, and Department of Psychiatry, School of Medicine and Medical Sciences, University College Dublin, St Vincent's University Hospital, Dublin, Ireland; Olesya Ajnakina, MSc PhD, Department of Psychosis Studies, IoPPN, King's College London, London, UK; Brendon Stubbs, MSc MCSP PhD, Health Service and Population Research Department, IoPPN, King's College London, and Physiotherapy Department, South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK; Michael Cullinane, MB MRCPsych, Young Adult Mental Health Services, St Fintan's Hospital, Portlaoise, Ireland; Kieran C. Murphy, MMedSci PhD FRCPI FRCPsych, Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Fiona Gaughran, MD FRCPI FRCP FRCPsych, National Psychosis Service, South London and Maudsley NHS Foundation Trust, IoPPN, Kings College London, and Collaboration for Leadership in Applied Health Research and Care, South London Psychosis Research Team, London, UK; Robin M. Murray, MD DSc FRCP FRCPsych FMedSci FRS, IoPPN, King's College London, and National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Kieran C Murphy
- John Lally, MB MSc MRCPsych, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK, and Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland, and Department of Psychiatry, School of Medicine and Medical Sciences, University College Dublin, St Vincent's University Hospital, Dublin, Ireland; Olesya Ajnakina, MSc PhD, Department of Psychosis Studies, IoPPN, King's College London, London, UK; Brendon Stubbs, MSc MCSP PhD, Health Service and Population Research Department, IoPPN, King's College London, and Physiotherapy Department, South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK; Michael Cullinane, MB MRCPsych, Young Adult Mental Health Services, St Fintan's Hospital, Portlaoise, Ireland; Kieran C. Murphy, MMedSci PhD FRCPI FRCPsych, Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Fiona Gaughran, MD FRCPI FRCP FRCPsych, National Psychosis Service, South London and Maudsley NHS Foundation Trust, IoPPN, Kings College London, and Collaboration for Leadership in Applied Health Research and Care, South London Psychosis Research Team, London, UK; Robin M. Murray, MD DSc FRCP FRCPsych FMedSci FRS, IoPPN, King's College London, and National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Fiona Gaughran
- John Lally, MB MSc MRCPsych, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK, and Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland, and Department of Psychiatry, School of Medicine and Medical Sciences, University College Dublin, St Vincent's University Hospital, Dublin, Ireland; Olesya Ajnakina, MSc PhD, Department of Psychosis Studies, IoPPN, King's College London, London, UK; Brendon Stubbs, MSc MCSP PhD, Health Service and Population Research Department, IoPPN, King's College London, and Physiotherapy Department, South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK; Michael Cullinane, MB MRCPsych, Young Adult Mental Health Services, St Fintan's Hospital, Portlaoise, Ireland; Kieran C. Murphy, MMedSci PhD FRCPI FRCPsych, Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Fiona Gaughran, MD FRCPI FRCP FRCPsych, National Psychosis Service, South London and Maudsley NHS Foundation Trust, IoPPN, Kings College London, and Collaboration for Leadership in Applied Health Research and Care, South London Psychosis Research Team, London, UK; Robin M. Murray, MD DSc FRCP FRCPsych FMedSci FRS, IoPPN, King's College London, and National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Robin M Murray
- John Lally, MB MSc MRCPsych, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK, and Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland, and Department of Psychiatry, School of Medicine and Medical Sciences, University College Dublin, St Vincent's University Hospital, Dublin, Ireland; Olesya Ajnakina, MSc PhD, Department of Psychosis Studies, IoPPN, King's College London, London, UK; Brendon Stubbs, MSc MCSP PhD, Health Service and Population Research Department, IoPPN, King's College London, and Physiotherapy Department, South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK; Michael Cullinane, MB MRCPsych, Young Adult Mental Health Services, St Fintan's Hospital, Portlaoise, Ireland; Kieran C. Murphy, MMedSci PhD FRCPI FRCPsych, Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Fiona Gaughran, MD FRCPI FRCP FRCPsych, National Psychosis Service, South London and Maudsley NHS Foundation Trust, IoPPN, Kings College London, and Collaboration for Leadership in Applied Health Research and Care, South London Psychosis Research Team, London, UK; Robin M. Murray, MD DSc FRCP FRCPsych FMedSci FRS, IoPPN, King's College London, and National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
9
|
Simonsen C, Faerden A, Romm KL, Berg AO, Bjella T, Sundet K, Ueland T, Andreassen O, Melle I. Early clinical recovery in first-episode psychosis: Symptomatic remission and its correlates at 1-year follow-up. Psychiatry Res 2017; 254:118-125. [PMID: 28460281 DOI: 10.1016/j.psychres.2017.04.050] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 04/05/2017] [Accepted: 04/23/2017] [Indexed: 01/20/2023]
Abstract
The aim was to gain more knowledge about early clinical recovery in first-episode psychosis (FEP). The interrelationship between symptomatic remission, poor global functioning and neurocognitive impairment was investigated. FEP participants (n =91) from the TOP study were investigated at baseline and 1-year follow-up. Symptomatic remission was defined by internationally standardized criteria. Poor global functioning was defined as GAF-F score ≤60. Neurocognitive impairment was defined as 1.5 standard deviation below healthy controls on a neuropsychological composite score. Finally, early clinical recovery was defined as symptomatic remission during the last 6 months and functional remission (1. GAF-F score ≥61, 2. at least 50% study/employment, and 3. living independently). At 1-year follow-up 26% were in symptomatic remission, predicted by duration of untreated psychosis and baseline positive symptoms. Significantly fewer in the symptomatic remission group had poor global functioning compared to the non-remission group, with no difference in the rate of neurocognitive impairment. Finally, 14% were considered in early clinical recovery. They had the same rate of neurocognitive impairment as the remaining group. These findings imply that symptomatic remission and early clinical recovery can already be identified at 1-year follow-up, and that this is relatively independent of neurocognitive impairment.
Collapse
Affiliation(s)
- Carmen Simonsen
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Postbox 4959 Nydalen, 0424 Oslo, Norway.
| | - Ann Faerden
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Postbox 4959 Nydalen, 0424 Oslo, Norway
| | - Kristin Lie Romm
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Postbox 4959 Nydalen, 0424 Oslo, Norway
| | - Akiah Ottesen Berg
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Postbox 4959 Nydalen, 0424 Oslo, Norway
| | - Thomas Bjella
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Postbox 4959 Nydalen, 0424 Oslo, Norway
| | - Kjetil Sundet
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Postbox 4959 Nydalen, 0424 Oslo, Norway; Department of Psychology, University of Oslo, Postbox 1094 Blindern, 0317 Oslo, Norway
| | - Torill Ueland
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Postbox 4959 Nydalen, 0424 Oslo, Norway; Department of Psychology, University of Oslo, Postbox 1094 Blindern, 0317 Oslo, Norway
| | - Ole Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Postbox 4959 Nydalen, 0424 Oslo, Norway
| | - Ingrid Melle
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Postbox 4959 Nydalen, 0424 Oslo, Norway
| |
Collapse
|
10
|
Haring L, Mõttus R, Kajalaid K, Koch K, Uppin K, Maron E, Vasar E. The course of cognitive functioning after first-episode of psychosis: A six month follow-up study. Schizophr Res 2017; 182:31-41. [PMID: 27746055 DOI: 10.1016/j.schres.2016.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/30/2016] [Accepted: 10/10/2016] [Indexed: 12/22/2022]
Abstract
Our aim with the present study was to evaluate rank-order and mean-level cognitive functioning stability among first-episode psychosis (FEP) patients, measured using the Cambridge Neuropsychological Test Automated Battery (CANTAB), over a six month period. We also aimed to examine longitudinal measurement invariance and identify factors-such as age, gender, educational level, treatment and psychopathological change scores-potentially linked to cognitive change among patients. In addition, correlations between objectively measured and subjectively evaluated cognitive functioning were estimated. Neuropsychological assessments were administered to 85 patients after the initial stabilisation of their psychosis; 82 of the patients were retested. Subjectively perceived cognitive functioning was measured using a subscale derived from the Estonian version of the Subjective Well-Being Under Neuroleptic Scale (SWN-K-E). On average, executive functioning and processing speed improved significantly, while memory test scores decreased significantly, over time. Very high rank-order stability (r=0.80 to 0.94, p<0.001) was observed with all measured ability scores. Confirmatory factor analysis revealed the loadings of a single (broad ability) factor model were equal across both measurement occasions, but the lack of intercept invariance suggested that mean-level comparisons are more appropriately carried out at a subtest level. On average psychopathology scores and antipsychotics doses declined over time, with the latter also significantly correlating with better executive functioning. Gender was a significant moderator of some domains of cognitive performance, and decline tended to be somewhat more pronounced for women. The results also indicated the lack of any relationship between objective and subjective measurements of cognitive functioning.
Collapse
Affiliation(s)
- Liina Haring
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia.
| | - René Mõttus
- Department of Psychology, University of Edinburgh, Edinburgh, UK; Department of Psychology, University of Tartu, Tartu, Estonia.
| | | | - Kadri Koch
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia.
| | - Kärt Uppin
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia.
| | - Eduard Maron
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia; North Estonia Medical Centre, Department of Psychiatry, Tallinn, Estonia; Centre for Mental Health, Imperial College London, UK.
| | - Eero Vasar
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia; Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Tartu, Estonia.
| |
Collapse
|
11
|
Lessard N, McNally-Gagnon A, Dubuc MJ, Forget J, Mottard JP, Leblanc J, Lassonde M. Preserved priming effect in individuals with schizophrenia: cues towards rehabilitation. Cogn Neuropsychiatry 2016; 20:512-25. [PMID: 26512433 DOI: 10.1080/13546805.2015.1100111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Individuals with schizophrenia and affective disorders show relatively intact implicit memory as compared to declarative memory. Implicit memory is usually assessed with skill learning and priming tasks. Whereas priming is thought to involve storage changes in the posterior neocortex, skill learning is thought to rely more on the corticostriatal pathway. Since frontostriatal and frontotemporal dysfunctions are, respectively, found in schizophrenia and affective disorders, we hypothesised that individuals with schizophrenia and first-episode psychosis would exhibit disturbances in skill learning, but not priming. METHODS Thirty-five patients (11 first-episode psychosis; 11 schizophrenia; 13 affective disorders) and 10 controls completed a procedural learning and priming task. Participants had to identify fragmented images throughout five training sessions. The improvement of the threshold at which the images could be identified between the first and last session was used as an index of procedural learning. In a final session, the identification thresholds for old and new images were compared to assess the priming effect. RESULTS Whereas individuals with schizophrenia and first-episode psychosis showed impaired skill learning, the priming effect was similar in all groups. CONCLUSION Even though some aspects of learning and memory are affected in schizophrenia, our results suggest that the posterior cortical pathway remains efficient at modulating the priming effect. This intact ability could be used to guide the elaboration of new rehabilitation programmes.
Collapse
Affiliation(s)
- Nadia Lessard
- a Hôpital du Sacré-Cœur de Montréal , Montréal , Québec , Canada.,b Department of Psychology , Université de Montréal , Montréal , Québec , Canada
| | | | | | - Julie Forget
- d Institut Saint-Pierre , Palavas-les-Flots , France
| | - Jean-Pierre Mottard
- a Hôpital du Sacré-Cœur de Montréal , Montréal , Québec , Canada.,e Department of Psychiatry , Université de Montréal , Montréal , Québec , Canada
| | - Jean Leblanc
- a Hôpital du Sacré-Cœur de Montréal , Montréal , Québec , Canada.,e Department of Psychiatry , Université de Montréal , Montréal , Québec , Canada
| | - Maryse Lassonde
- b Department of Psychology , Université de Montréal , Montréal , Québec , Canada
| |
Collapse
|
12
|
Guimond S, Chakravarty MM, Bergeron-Gagnon L, Patel R, Lepage M. Verbal memory impairments in schizophrenia associated with cortical thinning. Neuroimage Clin 2015; 11:20-29. [PMID: 26909322 PMCID: PMC4732190 DOI: 10.1016/j.nicl.2015.12.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 12/11/2015] [Accepted: 12/20/2015] [Indexed: 01/22/2023]
Abstract
Verbal memory (VM) represents one of the most affected cognitive domains in schizophrenia. Multiple studies have shown that schizophrenia is associated with cortical abnormalities, but it remains unclear whether these are related to VM impairments. Considering the vast literature demonstrating the role of the frontal cortex, the parahippocampal cortex, and the hippocampus in VM, we examined the cortical thickness/volume of these regions. We used a categorical approach whereby 27 schizophrenia patients with 'moderate to severe' VM impairments were compared to 23 patients with 'low to mild' VM impairments and 23 healthy controls. A series of between-group vertex-wise GLM on cortical thickness were performed for specific regions of interest defining the parahippocampal gyrus and the frontal cortex. When compared to healthy controls, patients with 'moderate to severe' VM impairments revealed significantly thinner cortex in the left frontal lobe, and the parahippocampal gyri. When compared to patients with 'low to mild' VM impairments, patients with 'moderate to severe' VM impairments showed a trend of thinner cortex in similar regions. Virtually no differences were observed in the frontal area of patients with 'low to mild' VM impairments relative to controls. No significant group differences were observed in the hippocampus. Our results indicate that patients with greater VM impairments demonstrate significant cortical thinning in regions known to be important in VM performance. Treating VM deficits in schizophrenia could have a positive effect on the brain; thus, subgroups of patients with more severe VM deficits should be a prioritized target in the development of new cognitive treatments.
Collapse
Affiliation(s)
- S Guimond
- Department of Psychology, McGill University, Canada; Douglas Mental Health University Institute, Canada
| | - M M Chakravarty
- Douglas Mental Health University Institute, Canada; Department of Psychiatry, McGill University, Canada
| | - L Bergeron-Gagnon
- Douglas Mental Health University Institute, Canada; Department of Psychology, University of Montreal, Canada
| | - R Patel
- Douglas Mental Health University Institute, Canada
| | - M Lepage
- Douglas Mental Health University Institute, Canada; Department of Psychiatry, McGill University, Canada.
| |
Collapse
|
13
|
Trampush JW, Lencz T, DeRosse P, John M, Gallego JA, Petrides G, Hassoun Y, Zhang JP, Addington J, Kellner CH, Tohen M, Burdick KE, Goldberg TE, Kane JM, Robinson DG, Malhotra AK. Relationship of Cognition to Clinical Response in First-Episode Schizophrenia Spectrum Disorders. Schizophr Bull 2015; 41:1237-47. [PMID: 26409223 PMCID: PMC4601719 DOI: 10.1093/schbul/sbv120] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
First-episode schizophrenia (FES) spectrum disorders are associated with pronounced cognitive dysfunction across all domains. However, less is known about the course of cognitive functioning, following the first presentation of psychosis, and the relationship of cognition to clinical course during initial treatment. The present longitudinal study examined the magnitude of neurocognitive impairment, using the MATRICS Consensus Cognitive Battery, in patients experiencing their first episode of psychosis at baseline and after 12 weeks of randomized antipsychotic treatment with either aripiprazole or risperidone. At baseline, FES patients evidenced marked impairments in cognitive functioning. Notably, performance on the mazes task of planning and reasoning significantly predicted the likelihood of meeting stringent criteria for positive symptom remission during the first 12 weeks of the trial. Performance on indices of general cognitive function, working memory, and verbal learning improved over time, but these improvements were mediated by improvements in both positive and negative symptoms. We did not detect any differential effects of antipsychotic medication assignment (aripiprazole vs risperidone) on cognitive functioning. Our results suggest that a brief paper-and-pencil measure reflecting planning/reasoning abilities may index responsivity to antipsychotic medication. However, improvements in cognitive functioning over time were related to clinical symptom improvement, reflecting "pseudospecificity."
Collapse
Affiliation(s)
- Joey W. Trampush
- *To whom correspondence should be addressed; Zucker Hillside Hospital, 75-59 263rd Street, Glen Oaks, NY 11004, US; tel: 718-470-5379, fax: 718-343-1659, e-mail:
| | | | - Pamela DeRosse
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY;,Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, North Shore-LIJ Health System, Manhasset, NY
| | - Majnu John
- Department of Mathematics, Hofstra University, Hempstead, NY
| | | | | | - Youssef Hassoun
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY
| | | | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Charles H. Kellner
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Mauricio Tohen
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM
| | | | - Terry E. Goldberg
- Litwin Zucker Center for the Study of Alzheimer’s Disease, Feinstein Institute for Medical Research, Hofstra North Shore-LIJ School of Medicine, Manhasset, NY, USA
| | | | | | | |
Collapse
|