Lack of association between clinical and cognitive change in first-episode psychosis: the first 6 weeks of treatment.
OBJECTIVE
To investigate potential changes and associations in clinical dimensions and cognitive functioning after the first 6 weeks of pharmacological treatment as the relation between cognitive and clinical change may have an impact in determining the importance of cognition as a treatment target.


METHODS
Patients (n = 42) completed a brief battery of 5 neurocognitive tests within 72 hours of commencing, and 6 weeks after, standard pharmacological treatment. The cognitive testing comprised 5 domains: attention, visuomotor speed, declarative memory, working memory, and executive function. Volunteers (n = 43) were recruited to control for practice effects.


RESULTS
Patients and control subjects improved over time in the raw scores in cognitive tests. Patients' performance, at baseline and end point assessments, was below that of the control subjects in all cognitive variables, except the Stroop interference score. No interaction effect between time and group was found. Further, after controlling for practice effects and adjusting for multiple comparisons, patients' cognitive performance showed no significant improvement. Accordingly, there was no association between clinical improvement and cognitive change. This lack of association was also observed in the subgroup of people who showed decreased scores in negative symptoms.


CONCLUSIONS
Cognitive response is not clearly enhanced by antipsychotic drugs and it is not a by-product of clinical recovery during the acute phase (first 6 weeks) of a first-episode nonaffective psychosis.
González-Blanch
César
C
Mental Health Centre, University Hospital Marqués de Valdecilla, University of Cantabria, Santander, Spain. cgblanch@terra.es
Crespo-Facorro
Benedicto
B
Alvarez-Jiménez
Mario
M
Rodríguez-Sánchez
José Manuel
JM
Pérez-Iglesias
Rocío
R
Pelayo-Terán
José María
JM
Martínez-García
Obdulia
O
Vázquez-Barquero
José Luis
JL
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006220:Haloperidol / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D000077152:Olanzapine; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D013223:Statistics as Topic; D055815:Young Adult
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D006220:Haloperidol; D018967:Risperidone; D000077152:Olanzapine