title: Neurocognitive and clinical predictors of functional outcome in patients with schizophrenia and bipolar I disorder at one-year follow-up.
abstract: OBJECTIVE
  Many studies have reported that cognitive ability may be predictive of the functional outcome for patients with schizophrenia. However, no study has prospectively examined these aspects in schizophrenia and bipolar disorders simultaneously. The present study attempted to analyze if neurocognition and clinical status predicts the real-life functioning for patients with schizophrenia or bipolar I disorder, using a longitudinal design.
  
  
  METHODS
  Forty-seven schizophrenic and 43 bipolar I outpatients were assessed twice with a neurocognitive battery (Executive Functions, Working Memory, Verbal Memory, Visual Memory, Visual-Motor Processing, Vigilance, Vocabulary and Motor Speed tasks), clinical scales (the Positive and Negative Symptom Scale, the Hamilton Rating Scale for Depression and the Clinician Administered Rating Scale for Mania) and functional outcome measures (the Global Assessment of Functioning Scale, the WHO's Disability Assessment Scale and occupational adaptation level) over a one-year follow-up period. The cognitive performance of the patients was compared, at baseline and one year later, with that of 25 healthy subjects.
  
  
  RESULTS
  In schizophrenia patients, global functioning one year later was predicted by a composite neurocognitive score and three specific domain (verbal memory, motor speed, vocabulary). Symptoms appeared to explain less of the variance in functioning. In bipolar I patients, changes in the composite neurocognitive score over one year, deficits in the visual/motor processing domain, severity of symptoms (psychotic, excitatory and affective symptoms) and premorbid adjustment at the first assessment were the variables that better predicted functioning or disability changes over follow-up period.
  
  
  CONCLUSIONS
  Although the relationships between cognition, symptoms and functional capacity differ for schizophrenia or bipolar I patients, neuropsychological performance seems to be a principal longitudinal predictor of functioning in both disorders. Baseline neurocognition and cognitive changes over 12 months predicted changes in functioning over the same period, but only in bipolar I patients. These cognitive domains could be potential neurocognitive endophenotypes (endophenocognitypes) with regard to bipolar I disorder.
authors.affiliation: The Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain. Rafael.Tabares@uv.es
authors.forename: Rafael
authors.initials: R
authors.lastname: Tabarés-Seisdedos
authors.forename: Vicente
authors.initials: V
authors.lastname: Balanzá-Martínez
authors.forename: José
authors.initials: J
authors.lastname: Sánchez-Moreno
authors.forename: Anabel
authors.initials: A
authors.lastname: Martinez-Aran
authors.forename: José
authors.initials: J
authors.lastname: Salazar-Fraile
authors.forename: Gabriel
authors.initials: G
authors.lastname: Selva-Vera
authors.forename: Cristina
authors.initials: C
authors.lastname: Rubio
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mata
authors.forename: Manuel
authors.initials: M
authors.lastname: Gómez-Beneyto
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
mesh_terms: D001714:Bipolar Disorder / Q000453:epidemiology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012559:Schizophrenia / Q000453:epidemiology*; D012720:Severity of Illness Index; D014888:Wechsler Scales; D055815:Young Adult