title: Free thyroxine levels are associated with cognitive changes in individuals with a first episode of psychosis: A prospective 1-year follow-up study.
abstract: The results of previous cross-sectional studies suggest that free thyroxine (FT4) levels are associated with cognitive abilities (particularly attention/vigilance) during the early stages of psychosis. We aimed to explore whether hypothalamic-pituitary-thyroid hormones predict cognitive changes in a 1-year longitudinal study following first episodes of psychosis (FEP). We studied 36 FEP patients and a control group of 50 healthy subjects (HS). Plasma levels of thyroid-stimulating hormone (TSH) and FT4 were measured. Cognitive assessment was performed with the MATRICS Cognitive Consensus Cognitive Battery (MCCB). FEP patients were assessed twice (baseline and after 1year), whereas HS were assessed only once. We compared cognitive changes at 1year between three groups based on baseline FT4 levels: 1) lowest quartile (Q1, FT4<1.16ng/dL); 2) medium quartiles (Q2-Q3, FT4 1.16-1.54ng/dL); and 3) highest quartile (Q4, FT4>1.54ng/dL). No differences in TSH or FT4 levels were found between HS and FEP patients. All participants had FT4 levels within the normal range. HS outperformed FEP patients in all cognitive tasks. In relation to the relationship between FT4 levels and cognitive changes, a U-shaped pattern was observed: FEP patients from the middle quartiles (Q2-Q3) improved in attention/vigilance, whereas both extreme quartiles (Q1 and Q4) showed a worsening in this cognitive domain over time. Patients with lower FT4 (Q1) showed poorer baseline attention; therefore, lower baseline FT4 levels predicted a poorer prognosis in terms of attention performance. Our study suggests that baseline FT4 levels are associated with changes in attention and vigilance performance over one year in FEP patients.
authors.affiliation: Department of Psychiatry, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain. Electronic address: jlabad@tauli.cat.
authors.forename: J
authors.initials: J
authors.lastname: Labad
authors.affiliation: Department of Psychiatry, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain.
authors.forename: J D
authors.initials: JD
authors.lastname: Barbero
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Gutiérrez-Zotes
authors.affiliation: Department of Psychiatry, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Montalvo
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Creus
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: Á
authors.initials: Á
authors.lastname: Cabezas
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Solé
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Algora
authors.affiliation: Department of Psychiatry, Hospital Nostra Senyora de Meritxell, Servei Andorrà d'Atenció Sanitària, Andorra.
authors.forename: G
authors.initials: G
authors.lastname: Garcia-Parés
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Vilella
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000097:blood* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood*; D055815:Young Adult
chemical_list: D013972:Thyrotropin; D013974:Thyroxine
keywords: Attention; Cognition; Psychosis; Schizophrenia; Thyroid; Thyroxine