title: Lack of an inverse relationship between duration of untreated psychosis and cognitive function in first episode schizophrenia.
abstract: This study assessed the relationship between duration of untreated psychosis (DUP) and cognitive measures in order to assess if longer DUP was associated with worse performance. One hundred two patients with first episode schizophrenia or schizoaffective disorder were assessed on cognitive measures of speed of processing, episodic memory, executive function, and visual spatial processing at baseline (when patients were drug naive and after 16 weeks of olanzapine or risperidone treatment), so that a change score could be derived. DUP was defined by the emergence of psychiatric symptoms and the emergence of psychotic symptoms. Data were analyzed correlationally, parametrically (after the group was divided into long and short DUP by median split), and by regression. We found that DUP for psychotic symptoms in this group of patients was long, with a median of 46 weeks. Neither correlational, parametric analyses in which DUP served as a class variable, nor multiple regression indicated that longer DUP was associated with worse cognition at baseline or smaller magnitude of improvement in cognition. Our results suggest that while early intervention may be critical for symptom amelioration by shortening DUP, early intervention for treatment of psychiatric symptoms may have little or no impact on cognitive function. Furthermore, assuming that cognition is a core symptom of schizophrenia, the notion that ongoing psychosis is somehow toxic for a variety of information processing domains appears questionable.
authors.affiliation: Psychiatry Research, Zucker Hillside Hospital, United States. tgoldber@nshs.edu
authors.forename: Terry E
authors.initials: TE
authors.lastname: Goldberg
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Burdick
authors.forename: Joanne
authors.initials: J
authors.lastname: McCormack
authors.forename: Barbara
authors.initials: B
authors.lastname: Napolitano
authors.forename: Raman C
authors.initials: RC
authors.lastname: Patel
authors.forename: Serge M
authors.initials: SM
authors.lastname: Sevy
authors.forename: Robert
authors.initials: R
authors.lastname: Goldman
authors.forename: Todd
authors.initials: T
authors.lastname: Lencz
authors.forename: Anil K
authors.initials: AK
authors.lastname: Malhotra
authors.forename: John M
authors.initials: JM
authors.lastname: Kane
authors.forename: Delbert G
authors.initials: DG
authors.lastname: Robinson
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D000077152:Olanzapine; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D018967:Risperidone / Q000627:therapeutic use*; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine