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Br J Psychiatry. 2008 Oct;193(4):297-304. doi: 10.1192/bjp.bp.107.040410.

Cognitive markers of short-term clinical outcome in first-episode psychosis.

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1
Douglas Mental Health University Institute, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.

Abstract

BACKGROUND:

Outcome from psychotic disorders is heterogeneous with poorer outcomes frequently identified too late to be influenced. Symptomatic ratings at 1 or more years following initiation of treatment have been related to cognition in first-episode psychosis. However, the relationship between cognition and early outcome remains unclear.

AIMS:

To determine whether specific cognitive domains could identify poor short-term outcome among individuals with first-episode psychosis.

METHOD:

One hundred and fifty-one individuals with first-episode psychosis were divided into two groups based on 6-month clinical data after the initiation of treatment. Six cognitive domains were compared among 78 participants with poor outcomes, 73 with good outcomes and 31 healthy controls.

RESULTS:

Lower performance on verbal memory (z-scores: poor outcome=-1.3 (s.d.=1.1); good outcome=-0.8 (s.d.=0.9); P=0.001) and working memory (poor outcome=-1.0 (s.d.=1.2); good outcome=-0.4 (s.d.=0.9); P=0.003) identified individuals with first-episode psychosis with a poor outcome after 6 months of treatment.

CONCLUSIONS:

The early identification of those individuals with first-episode psychosis with a poor clinical outcome may encourage clinicians to pay special attention to them in the form of alternative pharmacological and psychological treatments for a more favourable outcome in the long term.

PMID:
18827291
DOI:
10.1192/bjp.bp.107.040410
[Indexed for MEDLINE]
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