Social and clinical consequences of cognitive deficits in early psychosis: a two-year follow-up study of first-admitted patients.
OBJECTIVE
To explore whether baseline memory and executive deficits predicted poor social and clinical outcome over the 2 years following a first admission for psychosis, regardless of categorical diagnosis.


METHODS
Cognitive functioning was assessed in first-admitted subjects with psychosis (n=35) with a neuropsychological battery of tests measuring executive, language and memory functions. Social and clinical outcome were assessed at 6-monthly intervals over a two-year follow-up using multiple sources of information.


RESULTS
A dose-response relationship was found between visual and verbal memory performance at first admission and clinical outcome over the 2-year follow-up: the poorer the memory performance, the more likely the risk of presenting with psychotic symptoms and rehospitalization. Poor baseline performance on the WCST executive function predicted better medication adherence. No association was found between cognitive performance and occupational or residential outcome.


CONCLUSIONS
Cognitive performance was a better predictor of clinical than social outcome in this sample of first-episode patients. The association between cognitive deficits and poor social outcome may be more marked in subjects with chronic psychosis than in first-episode subjects. The finding that cognitive deficits predict better medication adherence is in need of further exploration.
Verdoux
Hélène
H
Department of Psychiatry, University Victor Segalen Bordeaux 2, Bordeaux, France. helene.verdoux@ipso.u-bordeaux2.fr
Liraud
Florence
F
Assens
François
F
Abalan
François
F
van Os
Jim
J
D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D009483:Neuropsychological Tests; D010343:Patient Admission; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D012917:Social Adjustment