title: The relationship between level of cognitive impairments and functional outcome trajectories in first-episode schizophrenia.
abstract: Although cognitive impairments are consistently linked to functional outcome in chronic schizophrenia, the relationship remains unclear for patients with first-episode schizophrenia. The objective of this present study was to determine whether there are distinct developmental trajectories for functional outcome in patients with different levels of baseline cognition. The present study has a multi-follow-up design, and includes data from six follow-ups over four years. Assessments were conducted yearly, apart from the first year where assessments were conducted every six months. A total of 28 patients with first-episode schizophrenia participated in the study, with 79% of patients retained at the 4-year follow-up. Cognition was assessed with MATRICS Consensus Cognitive Battery. Functional outcomes were obtained through Global functioning: Social and Global functioning: Role. Data were analyzed with linear multilevel models. Results suggest steady improvements in social and role functioning among the patients across the four year period. Baseline attention, verbal learning, and verbal working memory were significantly associated with social outcome. Role functioning was significantly associated with attention, verbal working memory, and reasoning/problem solving. Furthermore, the rate of change in social outcome varies among patients depending on their baseline level of attention and verbal working memory, with the lowest scoring group showing the least improvement over the years. The subgroup of patients with the largest cognitive impairments at the onset of the disorder shows limited improvements in social functioning compared to higher functioning groups.
authors.affiliation: Department of Psychology, University of Oslo, PO Box 1094, 0373 Oslo, Norway; Vestre Viken Hospital Trust, PO Box 800, 3004 Drammen, Norway. Electronic address: susie.fu@psykologi.uio.no.
authors.forename: Susie
authors.initials: S
authors.lastname: Fu
authors.affiliation: Department of Psychology, University of Oslo, PO Box 1094, 0373 Oslo, Norway; Division of Mental Health, Norwegian Institute of Public Health, PO Box 4404, 0403 Oslo, Norway. Electronic address: n.o.czajkowski@psykologi.uio.no.
authors.forename: Nikolai
authors.initials: N
authors.lastname: Czajkowski
authors.affiliation: Department of Psychology, University of Oslo, PO Box 1094, 0373 Oslo, Norway; Vestre Viken Hospital Trust, PO Box 800, 3004 Drammen, Norway. Electronic address: b.r.rund@psykologi.uio.no.
authors.forename: Bjørn Rishovd
authors.initials: BR
authors.lastname: Rund
authors.affiliation: Department of Psychology, University of Oslo, PO Box 1094, 0373 Oslo, Norway. Electronic address: a.k.torgalsboen@psykologi.uio.no.
authors.forename: Anne-Kari
authors.initials: AK
authors.lastname: Torgalsbøen
mesh_terms: D000208:Acute Disease; D003071:Cognition; D060825:Cognitive Dysfunction / Q000628:therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D012919:Social Behavior; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cognition; Functional outcome; Longitudinal; Psychosis; Recovery