title: The impact of cognitive reserve in the outcome of first-episode psychoses: 2-year follow-up study.
abstract: The concept of cognitive reserve (CR) suggests that the premorbid intelligence quotient (IQ), years of education and leisure activities provide more efficient cognitive networks and therefore allow a better management of some conditions associated to cognitive impairment. Fifty-two DSM-IV diagnosed FEP subjects were matched with 41 healthy controls by age, gender and parental socio-economic status. All subjects were assessed clinically, neuropsychologically and functionally at baseline and after a two-year follow-up. To assess CR at baseline, three proxies have been integrated: premorbid IQ, years of education-occupation and leisure activities. Higher CR was associated with better cognitive, functional and clinical outcomes at baseline. The CR proxy was able to predict working memory, attention, executive functioning, verbal memory and global composite cognitive score accounting for 48.9%, 19.1%, 16.9%, 10.8% and 14.9% respectively of the variance at two-year follow-up. CR was also significantly predictive of PANSS negative scale score (12.5%), FAST global score (13.4%) and GAF (13%) at two-year follow-up. In addition, CR behaved as a mediator of working memory (B=4.123) and executive function (B=3.298) at baseline and of working memory (B=5.034) at 2-year follow-up. An additional analysis was performed, in order to test whether this mediation could be attributed mainly to the premorbid IQ. We obtained that this measure was not enough by itself to explain this mediation. CR may contribute to neuropsychological and functional outcome. Specific programs addressed to improve cognition and functioning conducted at the early stages of the illness may be helpful in order to prevent cognitive and functional decline.
authors: Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain.
authors: S
authors: S
authors: Amoretti
authors: Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain. Electronic address: bernardo@clinic.ub.es.
authors: M
authors: M
authors: Bernardo
authors: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain; Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
authors: C M
authors: CM
authors: Bonnin
authors: Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain.
authors: M
authors: M
authors: Bioque
authors: Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
authors: B
authors: B
authors: Cabrera
authors: Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain.
authors: G
authors: G
authors: Mezquida
authors: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain; Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
authors: B
authors: B
authors: Solé
authors: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain; Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
authors: E
authors: E
authors: Vieta
authors: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain; Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
authors: C
authors: C
authors: Torrent
mesh_terms: D000293:Adolescent; D000328:Adult; D001288:Attention; D058245:Cognitive Reserve; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004522:Educational Status; D056344:Executive Function; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007360:Intelligence; D007899:Leisure Activities; D008297:Male; D008568:Memory; D008570:Memory, Short-Term; D009790:Occupations; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cognition; Cognitive reserve; Follow-up studies; Memory short-term; Neuropsychology; Psychotic disorders