title: Cognitive reserve as a predictor of two year neuropsychological performance in early onset first-episode schizophrenia.
abstract: BACKGROUND
  The concept of cognitive reserve (CR) has been defined as individual differences in the efficient utilization of brain networks which allow some people to cope better than others with brain pathology. CR has been developed mainly in the field of aging and dementia after it was observed that there appears to be no direct relationship between the degree of brain pathology and the severity of clinical manifestations of this damage. The present study applies the concept of CR to a sample of children and adolescents with a first episode of schizophrenia, aiming to assess the possible influence of CR on neuropsychological performance after two year follow-up, controlling for the influence of clinical psychopathology.
  
  
  METHODS
  35 patients meeting DSM-IV criteria for schizophrenia or schizoaffective disorder (SSD) and 98 healthy controls (HC) matched for age and gender were included. CR was assessed at baseline, taking into account premorbid IQ, educational-occupational level and leisure activities. Clinical and neuropsychological assessments were completed by all patients at two year follow-up.
  
  
  RESULTS
  The CR proxy was able to predict working memory and attention at two year follow-up. Verbal memory and cognitive flexibility were not predicted by any of the variables included in the regression model. The SSD group obtained lower scores than HC on CR. CR measures correctly classified 79.8% of the sample as being SSD or HC.
  
  
  CONCLUSIONS
  Lower scores on CR were observed in SSD than in HC and the CR measure correctly classified a high percentage of the sample into the two groups. CR may predict SSD performance on working memory and attention tasks.
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain. eserna@clinic.ub.es
authors.forename: Elena
authors.initials: E
authors.lastname: de la Serna
authors.forename: Susana
authors.initials: S
authors.lastname: Andrés-Perpiñá
authors.forename: Olga
authors.initials: O
authors.lastname: Puig
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Baeza
authors.forename: Igor
authors.initials: I
authors.lastname: Bombin
authors.forename: David
authors.initials: D
authors.lastname: Bartrés-Faz
authors.forename: Celso
authors.initials: C
authors.lastname: Arango
authors.forename: Ana
authors.initials: A
authors.lastname: Gonzalez-Pinto
authors.forename: Mara
authors.initials: M
authors.lastname: Parellada
authors.forename: María
authors.initials: M
authors.lastname: Mayoral
authors.forename: Montserrat
authors.initials: M
authors.lastname: Graell
authors.forename: Soraya
authors.initials: S
authors.lastname: Otero
authors.forename: Joan
authors.initials: J
authors.lastname: Guardia
authors.forename: Josefina
authors.initials: J
authors.lastname: Castro-Fornieles
mesh_terms: D000293:Adolescent; D001288:Attention; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D058245:Cognitive Reserve / Q000502:physiology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008570:Memory, Short-Term; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications*; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology