Individual trajectories of cognitive performance in first episode psychosis: a 2-year follow-up study
Fecha
2018Autor
Versión
Acceso abierto / Sarbide irekia
Tipo
Artículo / Artikulua
Versión
Versión aceptada / Onetsi den bertsioa
Identificador del proyecto
Impacto
|
10.1007/s00406-017-0857-z
Resumen
Individual changes over time in cognition in patients with psychotic disorders have been studied very little, especially in
the case of frst episode psychosis (FEP). We aimed to establish whether change in individual trajectories in cognition
over 2 years of a sample of 159 FEP patients was reliable and clinically signifcant, using the reliable change index (RCI)
and clinically signifcant chan ...
[++]
Individual changes over time in cognition in patients with psychotic disorders have been studied very little, especially in
the case of frst episode psychosis (FEP). We aimed to establish whether change in individual trajectories in cognition
over 2 years of a sample of 159 FEP patients was reliable and clinically signifcant, using the reliable change index (RCI)
and clinically signifcant change (CSC) methods. We also studied a sample of 151 matched healthy controls. Patients and
controls were assessed with a set of neuropsychological tests, as well as premorbid, clinical and functionality measures.
We analysed the course of cognitive measures over time, using analysis of variance, and the individual trajectories in the
cognitive measures with the regression-based RCI (RCISRB) and the CSC. The RCISRB showed that between 5.4 and 31.2%
of the patients showed deterioration patterns, and between 0.6 and 8.8% showed improvement patterns in these tests over
time. Patients showing better cognitive profles according to RCISRB (worsening in zero to two cognitive measures) showed
better premorbid, clinical and functional profles than patients showing deterioration patterns in more than three tests. When
combining RCISRB and CSC values, we found that less than 10% of patients showed improvement or deterioration patterns
in executive function and attention measures. These results support the view that cognitive impairments are stable over the
frst 2 years of illness, but also that the analysis of individual trajectories could help to identify a subgroup of patients with
particular phenotypes, who may require specifc interventions. [--]
Materias
First episode psychosis,
Longitudinal,
Cognition,
Reliable change index,
Schizophrenia,
Clinically signifcant change
Editor
Springer
Publicado en
European Archives of Psychiatry and Clinical Neuroscience (2018) 268, 699–711
Departamento
Universidad Pública de Navarra. Departamento de Ciencias de la Salud /
Nafarroako Unibertsitate Publikoa. Osasun Zientziak Saila
Versión del editor
Entidades Financiadoras
This work was supported by the Carlos III Health Institute
(European Regional Development Funds-ERDF) of the Spanish Ministry of Economic Afairs and Competitiveness (08/1026, 11/02831,
14/01621) and the Health Department of the Government of Navarra
(87/2014).