title: Neuropsychological impairments predict the clinical course in schizophrenia.
abstract: To add to the open question whether cognitive impairments predict clinical outcome in schizophrenia, a sample of 125 first episode patients was assessed at the onset and over one year of controlled long-term treatment within a study of the German Research Network on Schizophrenia. No relapse according to predefined criteria occurred within the first year, but a total of 29 patients fulfilled post-hoc criteria of "clinical deterioration". Impairments in cognitive functioning assessed by the Trail-Making Test B at the onset of long-term treatment differentiated between patients with vs. without later clinical deterioration and proved to be a significant predictor of the clinical course in a regression analysis outperforming initial clinical status as predictor. However, low sensitivity (72%) and specificity (51%) limit possibilities of a transfer to individual predictions. As a linear combination of neuropsychological and psychopathological variables obtained highest predictive validity, such a combination may improve the prediction of the course of schizophrenic disorders and may ultimately lead to a more efficient and comprehensive treatment planning.
authors.affiliation: Department of Psychiatry and Psychotherapy, Heinrich-Heine-University Düsseldorf-Rhineland State Clinics Düsseldorf, Bergische Landstrasse 2, Düsseldorf, Germany. woelwer@uni-duesseldorf.de
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wölwer
authors.forename: Jürgen
authors.initials: J
authors.lastname: Brinkmeyer
authors.forename: Mathias
authors.initials: M
authors.lastname: Riesbeck
authors.forename: Lena
authors.initials: L
authors.lastname: Freimüller
authors.forename: Ansgar
authors.initials: A
authors.lastname: Klimke
authors.forename: Michael
authors.initials: M
authors.lastname: Wagner
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Möller
authors.forename: Stefan
authors.initials: S
authors.lastname: Klingberg
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gaebel
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D004311:Double-Blind Method; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012372:ROC Curve; D012559:Schizophrenia / Q000150:complications*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D006220:Haloperidol