scholarly journals Sex Differences in Verbal Memory Predict Functioning Through Negative Symptoms in Early Psychosis

2020 ◽  
Vol 46 (6) ◽  
pp. 1587-1595 ◽  
Author(s):  
Gabriella Buck ◽  
Katie M Lavigne ◽  
Carolina Makowski ◽  
Ridha Joober ◽  
Ashok Malla ◽  
...  
Keyword(s):  
Sex Differences ◽  
Verbal Memory ◽  
Visual Memory ◽  
Parental Education ◽  
Negative Symptoms ◽  
Early Psychosis ◽  
First Episode ◽  
Severe Illness ◽  
Cognitive Domains

Abstract Verbal memory (VM) is one of the most affected cognitive domains in first-episode psychosis (FEP) and is a robust predictor of functioning. Given that healthy females demonstrate superior VM relative to males and that female patients show less-severe illness courses than male patients, this study examined whether normative sex differences in VM extend to FEP and influence functioning. Four hundred and thirty-five patients (299 males, 136 females) with affective or nonaffective psychosis were recruited from a catchment-based specialized FEP intervention service and 138 nonclinical controls (96 males, 42 females) were recruited from the same community. One of the two neurocognitive batteries comprising six cognitive domains (VM, visual memory, working memory, attention, executive function, processing speed) were administered at baseline. In patients, positive and negative symptoms were evaluated at baseline and functioning was assessed at 1-year follow-up. Patients were more impaired than controls on all cognitive domains, but only VM showed sex differences (both patient and control males performed worse than females), and these results were consistent across batteries. In patients, better baseline VM in females was related to better functioning after 1 year, mediated through fewer baseline negative symptoms. Supplemental analyses revealed these results were not driven by affective psychosis nor by age and parental education. Thus, normative sex differences in VM are preserved in FEP and mediate functioning at 1-year follow-up via negative symptoms. This study highlights the importance of investigating sex effects for understanding VM deficits in early psychosis and suggests that sex may be a disease-modifying variable with important treatment implications.

Duration of untreated psychosis and its correlates in first episode psychosis: results of the prospective 5-year follow-up study

2011 ◽  
Vol 26 (S2) ◽  
pp. 1534-1534
Author(s):  
Y. Zaytseva ◽  
I. Gurovich ◽  
A. Dorodnova ◽  
L. Movina ◽  
A. Shmukler
Keyword(s):  
Social Adjustment ◽  
Verbal Memory ◽  
Visual Memory ◽  
Negative Symptoms ◽  
Age Of Onset ◽  
Brain Regions ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Duration Of Untreated Psychosis

IntroductionDuration of untreated psychosis (DUP) is a potentially changeable prognostic factor which can also indicate neurodegenerative process in schizophrenia.ObjectiveTo examine the association of DUP with various characteristics of the course of schizophrenia in first episode patients during 5-year follow-up.MethodsOne-hundred-fourteen patients with first psychotic episodes who have been treated in naturalistic setting within Early Intervention Centre (Moscow Research Institute of Psychiatry) were included. Clinical, social and neuropsychological parameters were assessed using standardized instruments.ResultsThe mean duration of untreated psychotic symptoms before admission was 298.66 ± 447.35 days. According to the analysis DUP was found to be significantly associated with the mode of onset (r = 0.51, p ≤ 0.001) level of remission (r = 0.21–0.30, p ≤ 0.05), severity of positive symptoms and negative symptoms in remission mostly at 2nd, 3d and 4th years of observation, poorer level of social adjustment at the 5th year (r = 0.19, p ≤ 0.05). The effect of DUP remained significant after controlling for age, gender and diagnostic variables.Moreover, DUP correlated with the parameters of verbal memory, visual memory and spatial functions during the follow-up (r = 0.29–0.36, p ≤ 0.05, r = 0.28–0.30, p ≤ 0.05, respectively). No correlations have been found between DUP and the age of onset, number of relapses and their duration during 5-year follow-up as well as with other neurocognitive parameters (executive functioning, gnosis, praxis, attention).ConclusionsThe results of the study underline the prognostic value of DUP for predicting clinical and functional outcomes. Association between DUP and poor memory domains supports the notion of neurotoxicity of DUP grasping specific brain regions in schizophrenia.

The impact of cognitive reserve, cognition and clinical symptoms on psychosocial functioning in first-episode psychoses

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Silvia Amoretti ◽  
Adriane R Rosa ◽  
Gisela Mezquida ◽  
Bibiana Cabrera ◽  
María Ribeiro ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Verbal Memory ◽  
Negative Symptoms ◽  
Cognitive Reserve ◽  
Clinical Symptoms ◽  
First Episode ◽  
Cognitive Domains ◽  
The Impact ◽  
The Relationship

Abstract Background Functional impairment is a defining feature of psychotic disorders. A range of factors has been shown to influence functioning, including negative symptoms, cognitive performance and cognitive reserve (CR). However, it is not clear how these variables may affect functioning in first-episode psychosis (FEP) patients. This 2-year follow-up study aimed to explore the possible mediating effects of CR on the relationship between cognitive performance or specific clinical symptoms and functional outcome. Methods A prospective study of non-affective FEP patients was performed (211 at baseline and 139 at follow-up). CR was entered in a path analysis model as potential mediators between cognitive domains or clinical symptoms and functioning. Results At baseline, the relationship between clinical variables or cognitive performance and functioning was not mediated by CR. At follow-up, the effect of attention (p = 0.003) and negative symptoms (p = 0.012) assessed at baseline on functioning was partially mediated by CR (p = 0.032 and 0.016), whereas the relationship between verbal memory (p = 0.057) and functioning was mediated by CR (p = 0.014). Verbal memory and positive and total subscales of PANSS assessed at follow-up were partially mediated by CR and the effect of working memory on functioning was totally mediated by CR. Conclusions Our results showed the influence of CR in mediating the relationship between cognitive domains or clinical symptoms and functioning in FEP. In particular, CR partially mediated the relationship between some cognitive domains or clinical symptoms and functioning at follow-up. Therefore, CR could improve our understanding of the long-term functioning of patients with a non-affective FEP.

scholarly journals Impacts of duration of untreated psychosis on cognition and negative symptoms in first-episode schizophrenia: a 3-year prospective follow-up study

2012 ◽  
Vol 43 (9) ◽  
pp. 1883-1893 ◽  
Author(s):  
W. C. Chang ◽  
C. L. M. Hui ◽  
J. Y. M. Tang ◽  
G. H. Y. Wong ◽  
S. K. W. Chan ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Visual Memory ◽  
Negative Symptoms ◽  
Structured Interview ◽  
First Episode ◽  
Psychotic Episode ◽  
Duration Of Untreated Psychosis ◽  
Clinical Stabilization ◽  
First Episode Schizophrenia

BackgroundCognitive impairment is a core feature of schizophrenia. Its relationship with duration of untreated psychosis (DUP), a potentially malleable prognostic factor, has been less studied, with inconsistent findings being observed in the literature. Previous research investigating such a relationship was mostly cross-sectional and none of those prospective studies had a follow-up duration beyond 2 years.MethodA total of 93 Hong Kong Chinese aged 18 to 55 years presenting with first-episode schizophrenia-spectrum disorder were studied. DUP and pre-morbid adjustment were measured using a structured interview incorporating multiple sources of information. Psychopathological evaluation was administered at intake, after clinical stabilization of the first psychotic episode, and at 12, 24 and 36 months. Cognitive functions were measured at clinical stabilization, and at 12, 24 and 36 months.ResultsDUP exerted differential effects on various cognitive domains, with memory deficits being the most related to DUP even when potential confounders including pre-morbid adjustment and sex were adjusted. Prolonged DUP was associated with more severe impairment in visual memory at clinical stabilization and verbal memory at 24 and 36 months. Further, patients with a long DUP were found to have worse outcomes on negative symptoms at 36 months. The effects of DUP on verbal memory remained significant even when negative symptoms were taken into consideration.ConclusionsOur findings provided further supportive evidence that delayed treatment to first-episode psychosis is associated with poorer cognitive and clinical outcomes. In addition, DUP may specifically affect memory function and its adverse impact on verbal memory may only become evident at a later stage of the recovery process.

Group programmes for recovery from early psychosis

1998 ◽  
Vol 172 (S33) ◽  
pp. 117-121 ◽  
Author(s):  
Dianne J. Albiston ◽  
Shona M. Francey ◽  
Susan M. Harrigan
Keyword(s):  
Negative Symptoms ◽  
Positive Impact ◽  
Early Psychosis ◽  
First Episode ◽  
Premorbid Adjustment ◽  
Comprehensive Service ◽  
First Onset ◽  
Group Programme ◽  
The Impact

BackgroundWe evaluate the impact of a group-based, transitional, psychosocial programme, within a comprehensive service (the Early Psychosis Prevention and Intervention Centre, EPPIC), on recovery from first-episode psychosis.MethodIndividuals using the service (and meeting study criteria) were assessed on a range of symptom and functioning instruments at entry, after 6 weeks and 6 months. Participants received comprehensive case management and services according to their identified needs. Thirty-four people who had attended the group programme were compared at 6 month follow-up with 61 EPPIC patients who had not attended.ResultsThe people attending the group programme had a lower level of premorbid adjustment than the comparison group, and a trend towards exhibiting a higher level of negative symptoms, prior to commencing the group programme. However, at 6 month follow-up, no significant differences were found between the groups.ConclusionsInvolvement in the group programme may have had a positive impact on a subgroup of EPPIC subjects with poor level of premorbid adjustment, by providing a ‘holding pattern’ in the critical period following the emergence of first-onset psychosis, and thus prevented deterioration and the development of disability.

scholarly journals Three-Year Outcome of Treatment in an Early Psychosis Program

2009 ◽  
Vol 54 (9) ◽  
pp. 626-630 ◽  
Author(s):  
Jean Addington ◽  
Donald Addington
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Negative Symptoms ◽  
Family Physicians ◽  
Early Psychosis ◽  
First Episode ◽  
Significant Group ◽  
Specialized Mental Health

Objective: Studies defining the course and outcome of people experiencing their first episode psychosis (FEP) generally report an improvement in symptoms and functioning. Little is known about the follow-up arrangements offered topatients when their timein a FEP comes to an end. Method: Our study focuses on a sample of FEP patients ( n = 292) who were followed for up to 3 years in a multi-element specialized FEP service. Results: Improvement in positive symptoms and social functioning, but not negative symptoms, was observed in this sample both for people who completed 3 years in the program and for those who left early. About 40% were referred to specialized mental health services, whereas 24% were followed by their family physician. Patients who were followed by family physicians had decreased symptoms and improved functioning. Conclusion: Most patients treated in an early psychosis program will need follow-up, the largest group will require specialized mental health services in the community, but a significant group can be followed by family physicians.

scholarly journals S59. LINKING VERBAL MEMORY DEFICITS, HIPPOCAMPAL VOLUME, AND FUNCTIONING: SEX DIFFERENCES ARE CRUCIAL

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S55-S56
Author(s):  
Gabriella Buck ◽  
Katie Lavigne ◽  
Carolina Makowski ◽  
Ridha Joober ◽  
Ashok Malla ◽  
...  
Keyword(s):  
Sex Differences ◽  
Cognitive Deficits ◽  
Verbal Memory ◽  
Functional Outcomes ◽  
Negative Symptoms ◽  
Brain Regions ◽  
Control Group ◽  
Neurocognitive Deficits ◽  
Male Patients

Abstract Background Verbal memory (VM) is one of the most affected cognitive domains in individuals with a first episode of psychosis (FEP). In the general population, there are well-documented sex differences in VM such that males perform worse than females. This has implications for understanding cognitive deficits in psychosis given that male patients present with more severe negative symptoms and poorer functional outcomes, both of which are associated with cognitive deficits. There lacks, however, a clear understanding of how VM deficits might contribute to males’ poorer functioning. From a neuroanatomical perspective, VM relies on a network of brain regions, including the hippocampus (HC) as an important hub in the acquisition of new information. Interestingly, many of the brain regions that differ between males and females, including the HC, show structural abnormalities in psychosis. Thus, consideration of sex differences may be essential for better characterizing and understanding brain alterations in psychosis and their effects on cognition. The aims of the current research were to: (1) evaluate whether the propensity for poorer functional outcomes among FEP males is mediated by sex differences in VM; and (2) investigate whether HC volume mediates the effect of sex on VM. Methods 137 FEP (90 males, 47 females) and 81 controls (55 males, 26 females) completed a VM task (Wechsler Memory Scale or CogState Research Battery) and a structural MRI scan (1.5 Tesla). Patients were additionally assessed for negative symptoms (Scale for the Assessment of Negative Symptoms) at baseline and functioning (Social and Occupational Functioning Assessment Scale) at 1-year follow-up. Performance of the matched control group was used as normative data to derive VM z-scores. HC volumes were computed for each subject and hemisphere using the MAGeT brain algorithm. Mediation analyses were conducted using the PROCESS macro with SPSS. The behavioral model (‘sex VM negative symptoms functioning’) was performed in patients only, controlling for education; the imaging model (‘sex HC volume VM’) was performed in both groups and additionally controlled for age and total brain volume. Significance was assessed at 95% confidence intervals. Results The effect of sex on functioning at 1-year follow-up was fully mediated by verbal memory capacity and negative symptoms (β=0.54, CI=[0.12, 1.12]. Importantly, neither VM nor negative symptoms alone mediated the relationship between sex and functioning at 1-year follow-up. Left and right HC volumes, which were larger in males than in females in both groups, demonstrated a suppression effect on the relation between sex and verbal memory in patients (left HC: β=-0.21, CI=[-0.39, -0.07]; right HC: β=-0.24, CI=[-0.45,-0.09]), but not in controls (left HC: β=0.04, CI=[-0.14, 0.24]; right HC: β=0.06, CI=[-0.13,0.25]). Discussion This study reveals that sex differences in VM are robust and influence functioning through negative symptoms in FEP. Given that males are typically overrepresented in psychosis samples, it is possible that male patients chiefly contribute to associations between negative symptoms and neurocognitive impairments observed in previous studies in which sex was not explicitly examined. Further, our results suggest that the role of the HC in memory may be differentially affected by sex. This second model was specific to FEP, indicating that certain structure-function relationships are not consistent between patients and controls. Overall, such findings highlight the need to consider sex differences when developing personalized treatment plans and highlight neurocognitive deficits as a promising avenue for treatment.

Domain-Specific Cognitive Recovery after First-Ever Stroke: A 2-Year Follow-Up

2017 ◽  
Vol 24 (2) ◽  
pp. 117-127 ◽  
Author(s):  
Katri E.A. Turunen ◽  
Siiri P.K. Laari ◽  
Tatu V. Kauranen ◽  
Jenni Uimonen ◽  
Satu Mustanoja ◽  
...  
Keyword(s):  
Language Processing ◽  
Verbal Memory ◽  
Visual Memory ◽  
Cognitive Status ◽  
Cognitively Impaired ◽  
Cognitive Domains ◽  
Domain Specific ◽  
Cognitive Improvement ◽  
Cognitively Intact

AbstractObjectives: The aim of this work was to study the change in different cognitive domains after stroke during a 2-year follow-up. Method: We evaluated both neuropsychologically and neurologically a consecutive cohort of working-age patients with a first-ever stroke at baseline (within the first weeks), 6 months, and 2 years after stroke-onset. A total of 153 patients participated in all examinations and were compared to 50 healthy controls. Results: Forty-nine percent of the patients were cognitively impaired at baseline, 41% at 6 months, and 39% at 2-year follow-up. We analyzed seven cognitive domains (impairment rates at baseline and 2-year follow-up): psychomotor speed (34%; 23%), executive functions (27%; 17%), visual memory (21%; 4%), visuospatial function (20%; 14%), verbal memory (18%; 12%), basic language processing (baseline 11%; 6 months 5%), and reasoning (2 years 14%). The patients who were cognitively impaired at baseline improved more within 6 months, than either the controls or cognitively intact patients in all cognitive domains (all p<.05). Later on, between 6 months and 2 years, the domain-specific change scores did not differ between patients who were cognitively intact and impaired at 6 months. Also, the cognitive status (intact or impaired) remained the same in 90% of patients between 6-month and 2-year follow-ups. At 2 years, half of the patients, who were categorized cognitively impaired, were rated as well-recovered according to neurological evaluation. Conclusions: Most of the cognitive improvement took place within 6 months. Long-lasting cognitive impairment was common even after good neurological recovery. An early neuropsychological examination is essential in evaluating cognitive dysfunction and need for rehabilitation. (JINS, 2018, 24, 117–127)

Investigating cognitive deficits and symptomatology across pre-morbid adjustment patterns in first-episode psychosis

2009 ◽  
Vol 40 (5) ◽  
pp. 749-759 ◽  
Author(s):  
L. Béchard-Evans ◽  
S. Iyer ◽  
M. Lepage ◽  
R. Joober ◽  
A. Malla
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Verbal Memory ◽  
Visual Memory ◽  
First Episode Psychosis ◽  
First Episode ◽  
Cognitive Domains ◽  
Good Group ◽  
Episode Psychosis ◽  
Poor Group

BackgroundCognitive deficits in schizophrenia are well established and are known to be present during the first episode of a psychotic disorder. In addition, consistent heterogeneity within these impairments remains unexplained. One potential source of variability may be the level of pre-morbid adjustment prior to the onset of first-episode psychosis (FEP).MethodNinety-four FEP patients and 32 healthy controls were assessed at baseline on several neuropsychological tests comprising six cognitive domains (verbal memory, visual memory, working memory, processing speed, reasoning/problem-solving and attention) and an abbreviated version of the full IQ. A global neurocognitive domain was also computed. Pre-morbid adjustment patterns were divided into three distinct groups: stable-poor, stable-good and deteriorating course.ResultsBased on a cut-off of 0.8 for effect size, the stable-poor pre-morbid adjustment group was significantly more impaired on most cognitive domains and full IQ compared to the deteriorating group, who were more severely impaired on all measures compared to the stable-good group. The type of cognitive deficit within each subgroup did not differ and the results indicate that a global neurocognition measure may reliably reflect the severity of cognitive impairment within each subgroup.ConclusionsPre-morbid adjustment patterns prior to onset of psychosis are associated with severity but not type of cognitive impairment. Patients in the stable-poor group are generally more impaired compared to the deteriorating group, who are, in turn, more impaired than the stable-good group.

scholarly journals The clinical relevance of formal thought disorder in the early stages of psychosis: results from the PRONIA study

2021 ◽  
Author(s):  
Oemer Faruk Oeztuerk ◽  
Alessandro Pigoni ◽  
Julian Wenzel ◽  
Shalaila S. Haas ◽  
David Popovic ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Illness Severity ◽  
Early Psychosis ◽  
Thought Disorder ◽  
Severe Illness ◽  
Abstract Thinking ◽  
Functional Impairments ◽  
Formal Thought Disorder

Abstract Background Formal thought disorder (FTD) has been associated with more severe illness courses and functional deficits in patients with psychotic disorders. However, it remains unclear whether the presence of FTD characterises a specific subgroup of patients showing more prominent illness severity, neurocognitive and functional impairments. This study aimed to identify stable and generalizable FTD-subgroups of patients with recent-onset psychosis (ROP) by applying a comprehensive data-driven clustering approach and to test the validity of these subgroups by assessing associations between this FTD-related stratification, social and occupational functioning, and neurocognition. Methods 279 patients with ROP were recruited as part of the multi-site European PRONIA study (Personalised Prognostic Tools for Early Psychosis Management; www.pronia.eu). Five FTD-related symptoms (conceptual disorganization, poverty of content of speech, difficulty in abstract thinking, increased latency of response and poverty of speech) were assessed with Positive and Negative Symptom Scale (PANSS) and the Scale for the Assessment of Negative Symptoms (SANS). Results The results with two patient subgroups showing different levels of FTD were the most stable and generalizable clustering solution (predicted clustering strength value = 0.86). FTD-High subgroup had lower scores in social (pfdr < 0.001) and role (pfdr < 0.001) functioning, as well as worse neurocognitive performance in semantic (pfdr < 0.001) and phonological verbal fluency (pfdr < 0.001), short-term verbal memory (pfdr = 0.002) and abstract thinking (pfdr = 0.010), in comparison to FTD-Low group. Conclusions Clustering techniques allowed us to identify patients with more pronounced FTD showing more severe deficits in functioning and neurocognition, thus suggesting that FTD may be a relevant marker of illness severity in the early psychosis pathway.

Sign in / Sign up

Export Citation Format

Share Document