title: Premorbid adjustment and clinical correlates of cognitive impairment in first-episode psychosis. The PEPsCog Study.
abstract: BACKGROUND
  The extent to which socio-demographic, clinical, and premorbid adjustment variables contribute to cognitive deficits in first-episode schizophrenia spectrum disorders remains to be ascertained.
  
  
  OBJECTIVE
  To examine the pattern and magnitude of cognitive impairment in first-episode psychosis patients, the profile of impairment across psychosis subtypes and the associations with premorbid adjustment.
  
  
  METHODS
  226 first-episode psychosis patients and 225 healthy controls were assessed in the PEPsCog study, as part of the PEPs study.
  
  
  RESULTS
  Patients showed slight to moderate cognitive impairment, verbal memory being the domain most impaired compared to controls. Broad affective spectrum patients had better premorbid IQ and outperformed the schizophrenia and other psychosis groups in executive function, and had better global cognitive function than the schizophrenia group. Adolescent premorbid adjustment together with age, gender, parental socio-economic status, and mean daily antipsychotic doses were the factors that best explained patients' cognitive performance. General and adolescent premorbid adjustment, age and parental socio-economic status were the best predictors of cognitive performance in controls.
  
  
  CONCLUSIONS
  Poorer premorbid adjustment together with socio-demographic factors and higher daily antipsychotic doses were related to a generalized cognitive impairment and to a lower premorbid intellectual reserve, suggesting that neurodevelopmental impairment was present before illness onset.
authors.affiliation: Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain. Electronic address: mcuestaz@cfnavarra.es.
authors.forename: Manuel J
authors.initials: MJ
authors.lastname: Cuesta
authors.affiliation: Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Sánchez-Torres
authors.affiliation: Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
authors.forename: Bibiana
authors.initials: B
authors.lastname: Cabrera
authors.affiliation: Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Bioque
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Madrid, Spain.
authors.forename: Jessica
authors.initials: J
authors.lastname: Merchán-Naranjo
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
authors.forename: Iluminada
authors.initials: I
authors.lastname: Corripio
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Hospital Universitario de Álava, University of the Basque Country, Vitoria, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: González-Pinto
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón). University of Zaragoza, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lobo
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Reintegra Foundation, Oviedo, Spain.
authors.forename: Igor
authors.initials: I
authors.lastname: Bombín
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clínic de Neurociències. Hospital Clínic Universitari, Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: de la Serna
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Clinic Hospital (INCLIVA), Valencia, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Sanjuan
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Madrid, Spain.
authors.forename: Mara
authors.initials: M
authors.lastname: Parellada
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Psychiatry Department, Instituto Ramón y Cajal de Investigación Sanitaria (IRyCIS), Hospital Ramón y Cajal, Universidad de Alcalá, Madrid, Spain.
authors.forename: Jerónimo
authors.initials: J
authors.lastname: Saiz-Ruiz
authors.affiliation: Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Bernardo
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002648:Child; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications* / Q000453:epidemiology; D013223:Statistics as Topic; D055815:Young Adult
keywords: Cognition; First episode psychosis; Premorbid adjustment; Schizophrenia spectrum disorders