Neurocognition and its influencing factors in the treatment of schizophrenia-effects of aripiprazole, olanzapine, quetiapine and risperidone.
BACKGROUND
To examine influencing variables of neurocognition in patients with schizophrenia and to predict cognition during antipsychotic treatment.


METHODS
Data were obtained from patients with an acute episode of schizophrenia participating in two double-blind and one open label trial comparing the effects of different atypical antipsychotics on cognition. In total, 129 patients were enrolled in this analysis. Cognitive function was assessed at admission, week 4 and 8. Efficacy and tolerability were assessed weekly using the Positive and Negative Syndrome Scale (PANSS) and the Simpson Angus Sale (SAS). Patients were treated with aripirazole, olanzapine, quetiapine and risperidone. Regression analysis including mixed effect models was performed.


RESULTS
A significant improvement in all cognitive domains was observed from baseline to week 8. Regarding the antipsychotic treatment applied quetiapine seemed to achieve the most favourable cognitive improvement. Negative and depressive symptoms, the patient's age and the concomitant and antipsychotic treatment applied were observed to significantly influence and predict neurocognition.


CONCLUSIONS
The results may indicate that schizophrenia is a static disorder with trait and state dependent cognitive components especially in the memory domains. The influence of negative and depressive symptoms should be considered in daily clinical routine.
Riedel
M
M
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany.
Schennach-Wolff
R
R
Musil
R
R
Dehning
S
S
Cerovecki
A
A
Opgen-Rhein
M
M
Matz
J
J
Seemüller
F
F
Obermeier
M
M
Engel
R R
RR
Müller
N
N
Möller
H-J
HJ
Spellmann
I
I
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000150:complications* / Q000503:physiopathology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004347:Drug Interactions; D006801:Humans; D008568:Memory / Q000187:drug effects; D008569:Memory Disorders / Q000150:complications / Q000503:physiopathology; D008875:Middle Aged; D009474:Neurons / Q000187:drug effects*; D012559:Schizophrenia / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
D014150:Antipsychotic Agents