Cognitive markers of short-term clinical outcome in first-episode psychosis.
BACKGROUND
Outcome from psychotic disorders is heterogeneous with poorer outcomes frequently identified too late to be influenced. Symptomatic ratings at 1 or more years following initiation of treatment have been related to cognition in first-episode psychosis. However, the relationship between cognition and early outcome remains unclear.


OBJECTIVE
To determine whether specific cognitive domains could identify poor short-term outcome among individuals with first-episode psychosis.


METHODS
One hundred and fifty-one individuals with first-episode psychosis were divided into two groups based on 6-month clinical data after the initiation of treatment. Six cognitive domains were compared among 78 participants with poor outcomes, 73 with good outcomes and 31 healthy controls.


RESULTS
Lower performance on verbal memory (z-scores: poor outcome=-1.3 (s.d.=1.1); good outcome=-0.8 (s.d.=0.9); P=0.001) and working memory (poor outcome=-1.0 (s.d.=1.2); good outcome=-0.4 (s.d.=0.9); P=0.003) identified individuals with first-episode psychosis with a poor outcome after 6 months of treatment.


CONCLUSIONS
The early identification of those individuals with first-episode psychosis with a poor clinical outcome may encourage clinicians to pay special attention to them in the form of alternative pharmacological and psychological treatments for a more favourable outcome in the long term.
Bodnar
Michael
M
Douglas Mental Health University Institute, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
Malla
Ashok
A
Joober
Ridha
R
Lepage
Martin
M
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome; D055815:Young Adult
D014150:Antipsychotic Agents