Premorbid IQ subgroups in first episode non affective psychosis patients: Long-term sex differences in function and neurocognition

Ayesa-Arriola, Rosa; Setién-Suero, Esther; Neergaard, Karl David; Belzunces, Àuria Albacete; Contreras, Fernando Hernández; Haren, Neeltje E.M. van; Crespo‐Facorro, Benedicto

doi:10.1016/j.schres.2017.12.006

Cited by 30 publications

(23 citation statements)

References 43 publications

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“…Having a first psychotic break at an older age is a positive prognostic factor because it allows higher premorbid achievements, in terms of greater knowledge and experience in the world before the illness, and time for the development of better social skills and greater resilience 12 . This is also confirmed in the present study concerning the higher education achievements and higher premorbid IQs in females, in line with a former study in our group 13 . Our study confirmed as well the replicated finding of equivalent cognitive impairment among male and female FEP patients 14 .…”

Section: Discussionsupporting

confidence: 94%

Understanding sex differences in long-term outcomes after a first episode of psychosis

et al. 2020

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While sex differences in schizophrenia have long been reported and discussed, long-term sex differences in outcomes among first episode of psychosis (FEP) patients in terms of the efficacy of Early Intervention Services (EIS) has been an under-explored area. A total of 209 FEP patients (95 females and 114 males) were reassessed after a time window ranging from 8 to 16 years after their first contact with an EIS program (PAFIP) that we will call the 10-year PAFIP cohort. Multiple clinical, cognitive, functioning, premorbid, and sociodemographic variables were explored at 1-year, 3-year and 10-year follow-ups. At first contact, females were older at illness onset, had higher premorbid adjustment and IQ, and were more frequently employed, living independently, and accompanied by a partner and/or children. Existence of a schizophrenia diagnosis, and cannabis and alcohol consumption were more probable among men. During the first 3 years, women showed a significantly better response to minimal antipsychotic dosages and higher rates of recovery than men (50% vs. 30.8%). Ten years later, more females continued living independently and had partners, while schizophrenia diagnoses and cannabis consumption continued to be more frequent among men. Females also presented a lower severity of negative symptoms; however, functionality and recovery differences did not show significant differences (46.7% vs. 34.4%). Between the 3- and 10-year follow-up sessions, an increase in dosage of antipsychotics was observed. These results suggest that the better outcomes seen among women during the first 3 years (while they were treated in an EIS) were in the presence of more favourable premorbid and baseline characteristics. After an average period of 10 years, with the only difference being in negative symptoms course, outcomes for women approximated those of men, drawing particular attention to the increase in dosage of antipsychotic medication once FEP patients were discharged from the EIS program towards community-based services. These findings help to pose the question of whether it is advisable to target sexes and lengthen EIS interventions.

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Section: Discussionsupporting

confidence: 94%

Understanding sex differences in long-term outcomes after a first episode of psychosis

et al. 2020

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“…On the contrary, the second hypothesis was not fulfilled, as the neurocognition of FEP patients with the longest DAP did not deteriorate over the 3‐year reassessment. This finding suggests that regardless of the DAP, the neurocognitive course of FEP individuals is stable, as it has been demonstrated by other longitudinal studies (Ayesa‐Arriola et al, 2017;Barder et al, 2015;Rodríguez‐Sánchez et al, 2013").…”

Section: Discussionsupporting

confidence: 75%

Entire duration of active psychosis and neurocognitive performance in first‐episode non‐affective psychosis

Murillo-García

Setién-Suero

Pardo-de-Santayana³

et al. 2020

Early Intervention Psych

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Aim To explore if the entire duration of active psychosis (DAP) is related to neurocognitive performance at baseline and at 3‐year follow‐up in patients with first episode psychosis (FEP). Methods DAP was estimated for 481 FEP patients. A neuropsychological battery was administered to measure neurocognitive specific domains, and a global indicator of neurocognitive impairment (global deficits score, GDS) was calculated. According to the DAP quartiles, four subgroups were formed, and these were compared. In addition, a logistic regression analysis was carried out to predict neurocognitive impairment at 3‐year follow‐up. Results FEP patients with the longest DAP (more than 18.36 months) presented a more severe global neurocognitive impairment evidenced in their GDS, both at baseline (F = 5.53; p˂ .01) and at 3‐year follow‐up (F = 4.16; p˂ .01). Moreover, a subgroup of participants with DAP between 7.40 and 18.36 months showed a specific attentional decline over the 3‐year follow‐up (F = 3.089; p˂ .05).The logistic regression model showed that sex (Wald = 7.29, p < .010), premorbid adjustment (Wald = 7.24, p < .010), attention (Wald = 12.10, p < .001), verbal memory (Wald = 16.29, p < .001) and visual memory (Wald = 9.41, p < .010) were significant predictors of neurocognitive impairment 3 years after the FEP. The variables composing the DAP were not significant predictors in this model. Conclusions DAP seems to be related to global neurocognitive impairment in FEP patients. These findings contribute in several ways to our understanding of the effects of active psychosis on the brain, and provide the basis for future research.

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“…In this regard, the literature suggests that neurodevelopmental impairment is present before illness onset and that early insults to the brain are manifested through deviant neurodevelopmental trajectories before the onset of psychotic symptoms . However, other factors that could explain these results are the significant differences in years of schooling and socioeconomic level .…”

Section: Discussionmentioning

confidence: 99%

Cognitive reserve as an outcome predictor: first‐episode affective versus non‐affective psychosis

Amoretti

Cabrera

Torrent

et al. 2018

Acta Psychiatr Scand

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CR plays a differential role in the outcome of psychoses according to the diagnosis. Specifically, in order to address the needs of non-affective patients with low CR, cognitive rehabilitation treatments will need to be 'enriched' by adding pro-cognitive pharmacological agents or using more sophisticated approaches. However, a functional remediation therapy may be of choice for those with an affective psychosis and low CR.

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Premorbid IQ subgroups in first episode non affective psychosis patients: Long-term sex differences in function and neurocognition

Cited by 30 publications

References 43 publications

Understanding sex differences in long-term outcomes after a first episode of psychosis

Understanding sex differences in long-term outcomes after a first episode of psychosis

Entire duration of active psychosis and neurocognitive performance in first‐episode non‐affective psychosis

Cognitive reserve as an outcome predictor: first‐episode affective versus non‐affective psychosis

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