title: Neurocognition and Duration of Psychosis: A 10-year Follow-up of First-Episode Patients.
abstract: A substantial proportion of schizophrenia-spectrum patients exhibit a cognitive impairment at illness onset. However, the long-term course of neurocognition and a possible neurotoxic effect of time spent in active psychosis, is a topic of controversy. Furthermore, it is of importance to find out what predicts the long-term course of neurocognition. Duration of untreated psychosis (DUP), accumulated time in psychosis the first year after start of treatment, relapse rates and symptoms are potential predictors of the long-term course. In this study, 261 first-episode psychosis patients were assessed neuropsychologically on one or more occasions. Patients were tested after remission of psychotic symptoms and reassessed 1, 2, 5, and 10 years after inclusion. The neurocognitive battery consisted of California Verbal Learning Test, Wisconsin Card Sorting Test, Controlled Oral Word Association Task, Trail Making A and B, and Finger Tapping. We calculated a composite score by adding the z-scores of 4 tests that were only moderately inter-correlated, not including Finger Tapping. Data were analyzed by a linear mixed model. The composite score was stable over 10 years. No significant relationship between psychosis before (DUP) or after start of treatment and the composite score was found, providing no support for the neurotoxicity hypothesis, and indicating that psychosis before start of treatment has no significant impact on the course and outcome in psychosis. We found no association between symptoms and the neurocognitive trajectory. Stable remission during the first year predicted neurocognitive functioning, suggesting that the early clinical course is a good predictor for the long-term course.
authors.affiliation: Vestre Viken Hospital Trust, Drammen, Norway; Department of Psychology, University of Oslo, Oslo, Norway; b.r.rund@psykologi.uio.no.
authors.forename: Bjørn Rishovd
authors.initials: BR
authors.lastname: Rund
authors.affiliation: Department of Psychology, University of Oslo, Oslo, Norway;
authors.forename: Helene Eidsmo
authors.initials: HE
authors.lastname: Barder
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway;
authors.forename: Julie
authors.initials: J
authors.lastname: Evensen
authors.affiliation: Early Psychosis Intervention Center, Psychiatry East, Region Zealand, Roskilde, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;
authors.forename: Ulrik
authors.initials: U
authors.lastname: Haahr
authors.affiliation: Centre for Clinical Research in Psychosis, Psychiatric Division, Stavanger University Hospital, Stavanger, Norway;
authors.forename: Wenche
authors.initials: W
authors.lastname: ten Velden Hegelstad
authors.affiliation: Centre for Clinical Research in Psychosis, Psychiatric Division, Stavanger University Hospital, Stavanger, Norway; Faculty of Social Science,University of Stavanger, Stavanger, Norway;
authors.forename: Inge
authors.initials: I
authors.lastname: Joa
authors.affiliation: Centre for Clinical Research in Psychosis, Psychiatric Division, Stavanger University Hospital, Stavanger, Norway; Faculty of Social Science,University of Stavanger, Stavanger, Norway;
authors.forename: Jan Olav
authors.initials: JO
authors.lastname: Johannessen
authors.affiliation: Centre for Clinical Research in Psychosis, Psychiatric Division, Stavanger University Hospital, Stavanger, Norway;
authors.forename: Johannes
authors.initials: J
authors.lastname: Langeveld
authors.affiliation: Centre for Clinical Research in Psychosis, Psychiatric Division, Stavanger University Hospital, Stavanger, Norway; Institute of Psychiatry, University of Bergen, Bergen, Norway;
authors.forename: Tor Ketil
authors.initials: TK
authors.lastname: Larsen
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway;
authors.forename: Ingrid
authors.initials: I
authors.lastname: Melle
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Oslo, Norway;
authors.forename: Stein
authors.initials: S
authors.lastname: Opjordsmoen
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway;
authors.forename: Jan Ivar
authors.initials: JI
authors.lastname: Røssberg
authors.affiliation: Early Psychosis Intervention Center, Psychiatry East, Region Zealand, Roskilde, Denmark; Psychiatric Research Unit, Psychiatry Region Zealand, Roskilde, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Simonsen
authors.affiliation: Department of Psychology, University of Oslo, Oslo, Norway; NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway;
authors.forename: Kjetil
authors.initials: K
authors.lastname: Sundet
authors.affiliation: Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway.
authors.forename: Per
authors.initials: P
authors.lastname: Vaglum
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
authors.forename: Thomas
authors.initials: T
authors.lastname: McGlashan
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway;
authors.forename: Svein
authors.initials: S
authors.lastname: Friis
mesh_terms: D000293:Adolescent; D000328:Adult; D000341:Affective Disorders, Psychotic / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D000368:Aged; D003072:Cognition Disorders / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D012008:Recurrence; D012074:Remission Induction; D012559:Schizophrenia / Q000503:physiopathology* / Q000628:therapy; D012563:Schizophrenia, Paranoid / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D012565:Schizophrenic Psychology; D013997:Time Factors; D055815:Young Adult
keywords: DUP; neurocognition; neurotoxicity; relapse; schizophrenia; symptoms