title: Cognitive functioning in subjects with recent-onset psychosis from a low-middle-income environment: multiple-domain deficits and longitudinal evaluation.
abstract: Cognitive deficits are a key feature of recent-onset psychosis, but there is no consensus on whether such deficits are generalized or confined to specific domains. Besides, it is unclear whether cognitive deficits: a) are found in psychotic patients in samples from outside high-income countries; and b) whether they progress uniformly over time in schizophrenia and affective psychoses. We applied 12 tests organized into eight cognitive domains, comparing psychosis patients (n = 56, time from initial contact = 677.95+/-183.27 days) versus healthy controls (n=70) recruited from the same area of São Paulo, Brazil. Longitudinal comparisons (digit span and verbal fluency) were conducted between a previous assessment of the subjects carried out at their psychosis onset, and the current follow-up evaluation. Psychosis patients differed significantly from controls on five domains, most prominently on verbal memory. Cognitive deficits remained detectable in separate comparisons of the schizophrenia subgroup and, to a lesser extent, the affective psychosis subjects against controls. Longitudinal comparisons indicated significant improvement in schizophrenia, affective psychoses, and control subjects, with no significant group-by-time interactions. Our results reinforce the view that there are generalized cognitive deficits in association with recent-onset psychoses, particularly of non-affective nature, which persist over time.
authors.affiliation: Department of Psychiatry, Universidade de São Paulo (USP), São Paulo (SP), Brazil. ayresadriana@hotmail.com
authors.forename: Adriana
authors.initials: A
authors.lastname: de Mello Ayres
authors.forename: Marcia
authors.initials: M
authors.lastname: Scazufca
authors.forename: Paulo Rossi
authors.initials: PR
authors.lastname: Menezes
authors.forename: Eduardo Yoshio
authors.initials: EY
authors.lastname: Nakano
authors.forename: Ana Carolina B
authors.initials: AC
authors.lastname: Regina
authors.forename: Maristela S
authors.initials: MS
authors.lastname: Schaufelberger
authors.forename: Robin M
authors.initials: RM
authors.lastname: Murray
authors.forename: Philip K
authors.initials: PK
authors.lastname: McGuire
authors.forename: Teresa
authors.initials: T
authors.lastname: Rushe
authors.forename: Geraldo F
authors.initials: GF
authors.lastname: Busatto
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods; D000328:Adult; D000704:Analysis of Variance; D001288:Attention / Q000502:physiology; D001938:Brazil; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D007182:Income; D008137:Longitudinal Studies; D008297:Male; D008433:Mathematics; D008568:Memory / Q000502:physiology; D019964:Mood Disorders / Q000209:etiology; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000150:complications* / Q000523:psychology*; D012720:Severity of Illness Index; D014705:Verbal Behavior / Q000502:physiology; D055815:Young Adult