title: Psychotic symptoms, cognition and affect as predictors of psychosocial problems and functional change in first-episode psychosis.
abstract: OBJECTIVE
  To enable further understanding of how cognitive deficits and psychopathology impact psychosocial functioning in first-episode psychosis patients, we investigated how psychopathology and cognitive deficits are associated with psychosocial problems at baseline, and how these predict psychosocial functioning at 12 months follow-up. Also, we tested whether the effect of baseline psychopathology on psychosocial functioning decreases between baseline and 12 months and the effect of baseline cognition increases.
  
  
  METHODS
  Eight neurocognitive and four social cognitive subdomains and psychopathology (positive and negative symptoms, depression and anxiety) were assessed at baseline in 153 non-affective first-episode psychosis (FEP) patients. Psychosocial functioning (work/study, relationships, self-care, disturbing behavior and general psychosocial functioning) was assessed at baseline and 12 months. Spearman correlations were examined and backward regression models were computed to test our hypotheses.
  
  
  RESULTS
  At baseline, psychosocial functioning was associated strongest with positive and negative symptoms of all assessed clinical domains, followed by neurocognition and social cognition. In contrast, psychosocial functioning at 12 months was not predicted by psychotic symptoms, but rather by neurocognition, social cognition and depression. Change in social functioning in the first 12 months after baseline was predicted by positive and negative symptoms, but to a similar degree by neurocognition and social cognition.
  
  
  CONCLUSIONS
  Whereas psychotic symptoms show marked impact on psychosocial functioning at illness onset, cognitive deficits appear to be more accurate longitudinal predictors of psychosocial problems and functional recovery in the early course of psychosis.
authors.affiliation: Parnassia Psychiatric Institute, Center for Early Psychosis, The Hague, The Netherlands. Electronic address: l.stouten@parnassia.nl.
authors.forename: Luyken H
authors.initials: LH
authors.lastname: Stouten
authors.affiliation: Parnassia Psychiatric Institute, Center for Early Psychosis, The Hague, The Netherlands; Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Veling
authors.affiliation: Parnassia Psychiatric Institute, Center for Early Psychosis, The Hague, The Netherlands.
authors.forename: Winfried
authors.initials: W
authors.lastname: Laan
authors.affiliation: Parnassia Psychiatric Institute, Center for Early Psychosis, The Hague, The Netherlands.
authors.forename: Mischa
authors.initials: M
authors.lastname: van der Helm
authors.affiliation: Parnassia Psychiatric Institute, Center for Early Psychosis, The Hague, The Netherlands; Department of Clinical Psychology, VU University, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
authors.forename: Mark
authors.initials: M
authors.lastname: van der Gaag
mesh_terms: D000328:Adult; D000339:Affect; D001007:Anxiety; D003071:Cognition; D003863:Depression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology*; D012044:Regression Analysis
keywords: Affect; First-episode psychosis; Neurocognition; Psychosocial functioning; Social cognition