Cognitive changes in patients with acute phase psychosis—Effects of illicit drug use

Abstract

Illicit drug use may influence cognition in non-affective psychosis. Previous studies have shown better cognition in psychosis with illicit drug use as compared to psychosis only. Possibly, illicit drug using patients have more transient drug-related cognitive deficits. Thus, the aim of the present study was to examine cognitive change the first weeks after admission to a psychiatric emergency ward, expecting more cognitive improvement at follow-up in the illicit drug group as compared to psychosis only. Patients with acute non-affective psychosis with (26%) and without illicit drug use were examined at baseline (n=123) and follow-up (n=67), with alternative forms of the Repeatable Battery for the Assessment of Neuropsychological Status. Latent Growth Curve models, controlling for cognition at baseline and age differences between the groups, were used to analyze cognitive change. The illicit drug using patients showed the largest improvement in cognition, especially among the youngest patients. Younger patients with non-affective psychosis and illicit drug use showed more cognitive improvement the first weeks after acute psychosis as compared to psychosis only. This suggests that the illicit drug users constitute a sub-group with less stable cognitive deficits and less cognitive vulnerability.

The Cannabis Pathway to Non-Affective Psychosis may Reflect Less Neurobiological Vulnerability

“…In a continuation of this study, we improved the design by focusing on the period when the patients were in-patients to control for the illicit drug use after admission to the acute ward in a total sample of 123 patients ( 135 , 136 ). The patients were examined by the Battery for the Assessment of Neuropsychological Status (RBANS) with alternative forms to minimize practice effects ( 95 , 137 , 138 ) at baseline and follow-up (mean time to follow-up 4 weeks).…”

The importance of clinical normative data for conceptualizing neuropsychological deficits in people with schizophrenia spectrum disorders

“…The RBANS has been used to measure cognitive impairment in schizophrenia spectrum disorders in North America, Europe, and Asia (Anda et al, 2016;Azizian, Yeghiyan, Ishkhanyan, Manukyan, & Khandanyan, 2011;Chianetta, Lefebvre, LeBlanc, & Grignon, 2008;de Girolamo et al, 2014;De la Torre et al, 2016;Dickerson et al, 2004;Ehrenreich et al, 2007;Gogos et al, 2010;Gold et al, 1999; Hal asz, Levy-Gigi, Han et al, 2012;Harris et al, 2004;Helle et al, 2014;Hobart et al, 1999;Iverson et al, 2009;Juh asz, Kem eny, Linka, S antha, & Bartk o, 2003;Kelemen, Kiss, Benedek, & K eri, 2013;Loughland et al, 2007;Raudeberg et al, 2019;Sanz, Vargas, & Mar ın, 2009;Takeuchi et al, 2013;Wang et al, 2019;Wilk et al, 2004;Zhang, Han et al, 2015;Zhang, Li et al, 2015;Zhang et al, 2012Zhang et al, , 2018. It might be helpful to replicate the present study (Iverson et al, 2009 andWilk et al, 2004) in a few more countries to extract common themes of impairment in schizophrenia spectrum disorders across cultures.…”

“…People with schizophrenia spectrum disorders usually experience cognitive impairments (Anda et al, 2016;Barder et al, 2013;Dickerson et al, 2004;Gogos, Joshua, & Rossell, 2010;Helle et al, 2014;Hobart, Goldberg, Bartko, & Gold, 1999;Iverson, Brooks, & Haley, 2009;Keefe, 2014;Øie, Sundet, & Ueland, 2011;Sponheim et al, 2010;Wilk et al, 2004;Zhang et al, 2012Zhang et al, , 2018. On average, they perform one to two standard deviations below the general population on tests of attention (Holmen, Juuhl-Langseth, Thormodsen, Melle, & Rund, 2010), learning and memory (Barder et al, 2013;Egeland et al, 2003), processing speed (Schaefer, Giangrande, Weinberger, & Dickinson, 2013), and executive functioning (Reichenberg et al, 2010).…”

“…The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is commonly used in research and clinical practice with people with schizophrenia (De la Torre, Perez, Ramallo, Randolph, & Gonz alez-Villegas, 2016;Dickerson et al, 2004;Gogos et al, 2010;Harris et al, 2004;Helle et al, 2014;Hobart et al, 1999;Iverson et al, 2009;Loughland, Lewin, Carr, Sheedy, & Harris, 2007;Tucker & Bertke, 2019;Wang et al, 2019;Wilk et al, 2004;Zhang, Han et al, 2015;Zhang, Li et al, 2015;Zhang et al, 2012). Two prior studies have provided clinical normative data for the RBANS in people with schizophrenia disorders, one in the United States (Wilk et al, 2004) and one in Canada (Iverson et al, 2009).…”

The positive link between executive function and lifetime cannabis use in schizophrenia is not explained by current levels of superior social cognition

“…The present study sought to test whether social cognition can explain the relationship between executive function and cannabis use. To increase the validity of the social cognition assessment both ToM and affect recognition were included, and stabilized patients were recruited since executive function and social cognition may fluctuate in the acute phase of psychosis (Balogh et al, 2014;Helle et al, 2014). ToM and affect recognition were included as these factors are most closely related to successfully interaction with other people.…”