title: Symptomatic remission and cognitive impairment in first-episode schizophrenia: a prospective 3-year follow-up study.
abstract: OBJECTIVE
  Cognitive impairment is a core feature of schizophrenia, but its relationship with symptomatic remission has been understudied. This study aimed to examine the concurrent and longitudinal relationships between cognitive functioning and symptomatic remission in first-episode schizophrenia.
  
  
  METHODS
  The sample comprised 92 Chinese patients, aged 18 to 55 years, who presented with first-episode DSM-IV schizophrenia spectrum disorder and were recruited from both outpatient and inpatient psychiatric units covering a defined catchment area in Hong Kong. The study commenced in September 1997 and ended in March 2005. Psychopathological evaluation was conducted using the Positive and Negative Syndrome Scale (PANSS) and the High Royds Evaluation of Negativity (HEN) scale at intake, after clinical stabilization of the first psychotic episode, and at 12, 24, and 36 months. Cognitive functions were measured at clinical stabilization and at 12, 24, and 36 months. Sustained symptomatic remission was operationally defined as fulfillment of mild severity ratings or less at 24 and 36 months on selected PANSS items for positive symptoms and on the basis of Andreasen's criteria and HEN subscales for negative symptoms.
  
  
  RESULTS
  At the end of the 3-year follow-up, 44.6% of patients achieved sustained symptomatic remission. Remitted patients had significantly better concurrent verbal memory (F = 4.6, P < .01) and functional (t = -2.4, P < .05) and vocational (t = 4.8, P < .01) outcomes at 36 months than nonremitted counterparts. Sustained remission attainment was associated with better premorbid adjustment (t = -3.1, P < .01), better baseline occupational status (χ(2) = 4.7, P < .05), better 1-year verbal memory (F = 6.4, P < .01), and fewer 1-year positive (t = -2.9, P < .01) and negative (t = -4.7, P < .01) symptoms. Logistic regression indicated that verbal memory impairment, premorbid functioning, and negative symptom severity independently predicted remission status (Nagelkerke R(2) = 0.425, P < .0001).
  
  
  CONCLUSIONS
  Our findings provide supportive evidence that verbal memory impairment might be specifically related to attainment of sustained remission in the early stage of schizophrenia.
authors: Department of Psychiatry, Queen Mary Hospital, 102 Pokfulam Rd, Hong Kong, PR China changwc@hku.hk.
authors: Wing Chung
authors: WC
authors: Chang
authors: Christy Lai
authors: CL
authors: Ming Hui
authors: Gloria Hoi
authors: GH
authors: Yan Wong
authors: Sherry Kit
authors: SK
authors: Wa Chan
authors: Edwin Ho
authors: EH
authors: Ming Lee
authors: Eric Yu
authors: EY
authors: Hai Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006723:Hong Kong; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology*; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy; D012565:Schizophrenic Psychology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents