Course of neurocognitive deficits in the prodrome and first episode of schizophrenia.
Understanding the trajectory of cognitive changes in the development of schizophrenia may shed light on the neurodevelopmental processes in the beginning stage of illness. Subjects at risk for psychosis (AR, n = 48), patients in their first episode of schizophrenia (FE, n = 20), and normal comparison subjects (n = 29) were assessed on a neurocognitive battery at baseline and at a 6-month follow-up. There were significant group differences across all cognitive domains as well as a significant group by time interaction in the verbal learning domain. After statistically controlling for practice effects and regression to the mean, a high proportion of FE subjects showed an improvement in verbal learning, and a significant number of AR subjects improved in general intelligence. Moreover, a higher than expected percentage of FE subjects, as well as AR subjects who later converted to psychosis, showed a deterioration in working memory and processing speed. These inconsistent trajectories suggest that some domains may improve with stabilization in the early stages of psychosis, whereas others may decline with progression of the illness, indicating possible targets for cognitive remediation strategies and candidate vulnerability markers for future psychosis.
Jahshan
Carol
C
Joint Doctoral Program in Clinical Psychology, San Diego State University.
Heaton
Robert K
RK
Department of Psychiatry, University of California.
Golshan
Shahrokh
S
Department of Psychiatry, University of California.
Cadenhead
Kristin S
KS
Department of Psychiatry, University of California.
D000293:Adolescent; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D012919:Social Behavior; D055815:Young Adult