Improvement and decline of cognitive function in schizophrenia over one year: a longitudinal investigation using latent growth modelling.
BACKGROUND
Long-term follow-up studies of people with schizophrenia report stability of cognitive performance; less is known about any shorter-term changes in cognitive function.


METHODS
This longitudinal study aimed to establish whether there was stability, improvement or decline in memory and executive functions over four assessments undertaken prospectively in one year. Cognitive performance was assessed during randomized controlled trials of first- and second-generation antipsychotic medication. Analyses used a latent growth modeling approach, so that individuals who missed some testing occasions could be included and trajectories of cognitive change explored despite missing data.


RESULTS
Over the year there was significant decline in spatial recognition but no change in pattern recognition or motor speed. Improvement was seen in planning and spatial working memory tasks; this may reflect improved strategy use with practice. There were significant individual differences in the initial level of performance on all tasks but not in rate of change; the latter may have been due to sample size limitations. Age, sex, premorbid IQ and drug class allocation explained significant variation in level of performance but could not predict change. Patients randomized to first-generation drugs improved more quickly than other groups on the planning task.


CONCLUSIONS
We conclude that cognitive change is present in schizophrenia but the magnitude of change is small when compared with the large differences in cognitive function that exist between patients. Analyses that retain patients who drop out of longitudinal studies, as well as those who complete testing protocols, are important to our understanding of cognition in schizophrenia.
Barnett
Jennifer H
JH
University of Cambridge Department of Psychiatry, Addenbrooke's Hospital, Cambridge, UK. jhb32@cam.ac.uk
Croudace
Tim J
TJ
Jaycock
Sue
S
Blackwell
Candice
C
Hynes
Fiona
F
Sahakian
Barbara J
BJ
Joyce
Eileen M
EM
Jones
Peter B
PB
D000328:Adult; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008568:Memory; D008875:Middle Aged; D008960:Models, Psychological; D010364:Pattern Recognition, Visual; D012559:Schizophrenia / Q000150:complications; D012565:Schizophrenic Psychology; D013647:Task Performance and Analysis