Treatment response and its correlates with cognitive functions in first-episode psychosis

Abstract

This study aims to explore the relationship between treatment response and cognitive function in the first 20 months of a psychosis. A total of 153 patients (69 males, 84 females) experiencing first-episode psychosis were recruited and tested with a set of neurocognitive tasks upon admission, discharge, and every 4 months up to 20 months thereafter. Neurocognitive domains included attention (Continuous Performance Test), memory (Logical Memory Test, Visual Reproduction, and Digit Forward Span), and executive function (Verbal Fluency Test and Wisconsin Card Sorting Test). Treatment response was determined by the scores of positive and negative symptoms rated with the Positive and Negative Syndrome Scales by their clinicians at discharge. For each group of symptoms, two groups of patients were identified. Patients with no item scored higher than 2 fell into the remission group (RG), and those had at least one item scored 4 or higher went to the treatment resistant group (TRG).. Performance on the neurocognitive tests of the two groups was compared. Results showed that the TRG, no matter classified by positive symptoms (n = 27) or negative symptoms (n = 34), performed consistently more poorly than the RG (by positive symptoms, n = 92; by negative symptoms, ns64. in all cognitive domains at each time point. The difference was more profound for groups classified by negative symptoms. The results suggest that treatment response, especially that in negative symptoms, may be related to cognitive impairment in psychosis.