Cognitive performance at first episode of psychosis and the relationship with future treatment resistance: Evidence from an international prospective cohort study

被引：3

作者：

Millgate, Edward ^{[1
]}

Smart, Sophie E. ^{[2
]}

Pardinas, Antonio F. ^{[2
]}

Kravariti, Eugenia ^{[1
]}

Ajnakina, Olesya ^{[3
,4
]}

Kapinska, Adrianna P. ^{[1
]}

Andreassen, Ole A. ^{[5
,6
]}

Barnes, Thomas R. E. ^{[7
]}

Berardi, Domenico ^{[8
]}

Crespo-Facorro, Benedicto ^{[9
,10
]}

D'Andre, Giuseppe ^{[8
]}

Demjaha, Arsime ^{[1
]}

Di Forti, Marta ^{[11
,12
]}

Doody, Gillian A. ^{[13
]}

Kassoumeri, Laura ^{[1
]}

Ferchiou, Aziz ^{[14
,15
]}

Guidi, Lorenzo ^{[16
]}

Joyce, Eileen M. ^{[17
]}

Lastrina, Ornella ^{[16
]}

Melle, Ingrid ^{[5
,6
]}

Pignon, Baptiste ^{[15
]}

Richard, Jean-Romain ^{[14
]}

Simonsen, Carmen ^{[5
,18
]}

Szoke, Andrei ^{[14
,15
]}

Tarricone, Ilaria ^{[16
]}

Tortelli, Andrea ^{[14
,19
]}

Vazquez-Bourgon, Javier ^{[10
,20
,21
]}

Murray, Robin M. ^{[1
]}

Walters, James T. R. ^{[2
]}

MacCabe, James H. ^{[1
]}

机构：

[1] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychosis Studies, London, England

[2] Cardiff Univ, MRC Ctr Neuropsychiat Genet & Genom, Div Psychol Med & Clin Neurosci, Cardiff, Wales

[3] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Biostat & Hlth Informat, London, England

[4] UCL, Inst Epidemiol & Hlth Care, Dept Behav Sci & Hlth, London, England

[5] Univ Oslo, Inst Clin Med, Norwegian Ctr Mental Disorders Res NORMENT, Oslo, Norway

[6] Oslo Univ Hosp, Div Mental Hlth & Addict, Oslo, Norway

[7] Imperial Coll London, Div Psychiat, London, England

[8] Alma Mater Studiorum Univ Bologna, Dept Biomed & Neuromotor Sci, Psychiat Unit, Bologna, Italy

[9] Univ Seville, Hosp Univ Virgen del Rocio, Dept Psychiat, IBiS, Seville, Spain

[10] Ctr Invest Red Salud Mental CIBERSAM, Seville, Spain

[11] Kings Coll London, Inst Psychiat Psychol & Neurosci, Social Genet & Dev Psychiat, London, England

[12] South London & Maudsley NHS Mental Hlth Fdn Trust, London, England

[13] Univ Nottingham, Dept Med Educ, Fac Med & Hlth Sci, Nottingham, England

[14] Univ Paris Est Creteil, INSERM, IMRB, Translat Neuropsychiat,Fdn FondaMental, Creteil, France

[15] Hop Univ H Mondor, AP HP, DMU IMPACT, FHU ADAPT, Creteil, France

[16] Alma Mater Studiorum Univ Bologna, Dept Med & Surg Sci, Bologna Transcultural Psychosomat Team BoTPT, Bologna, Italy

[17] UCL, UCL Queen Sq Inst Neurol, Dept Clin & Movement Neurosci, London, England

[18] Oslo Univ Hosp, Div Mental Hlth & Addict, Early Intervent Psychosis Advisory Unit South Eas, Oslo, Norway

[19] Grp Hosp Univ Psychiat Neurosci Paris, Pole Psychiat Precar, Paris, France

[20] Univ Hosp Marques de Valdecilla, Dept Psychiat, Inst Invest Marques Valdecilla IDIVAL, Santander, Spain

[21] Univ Cantabria, Sch Med, Dept Med & Psychiat, Santander, Spain

来源：

SCHIZOPHRENIA RESEARCH | 2023年 / 255卷

基金：

英国医学研究理事会; 英国惠康基金;

关键词：

Cognition; First episode psychosis; Treatment resistance; Prospective cohort; Schizophrenia; Psychosis; NEGATIVE SYMPTOMS; 1ST-EPISODE SCHIZOPHRENIA; UNTREATED PSYCHOSIS; GENDER-DIFFERENCES; LIFE-SPAN; CLOZAPINE; METAANALYSIS; GUIDELINES; PREDICTORS; DIAGNOSIS;

D O I：

10.1016/j.schres.2023.03.020

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

Background: Antipsychotic treatment resistance affects up to a third of individuals with schizophrenia, with recent research finding systematic biological differences between antipsychotic resistant and responsive patients. Our aim was to determine whether cognitive impairment at first episode significantly differs between future antipsychotic responders and resistant cases.Methods: Analysis of data from seven international cohorts of first-episode psychosis (FEP) with cognitive data at baseline (N = 683) and follow-up data on antipsychotic treatment response: 605 treatment responsive and 78 treatment resistant cases. Cognitive measures were grouped into seven cognitive domains based on the pre existing literature. We ran multiple imputation for missing data and used logistic regression to test for associ-ations between cognitive performance at FEP and treatment resistant status at follow-up.Results: On average patients who were future classified as treatment resistant reported poorer performance across most cognitive domains at baseline. Univariate logistic regressions showed that antipsychotic treatment resis-tance cases had significantly poorer IQ/general cognitive functioning at FEP (OR symbolscript 0.70, p symbolscript .003). These findings remained significant after adjusting for additional variables in multivariable analyses (OR symbolscript 0.76, p symbolscript .049).Conclusions: Although replication in larger studies is required, it appears that deficits in IQ/general cognitive functioning at first episode are associated with future treatment resistance. Cognitive variables may be able to provide further insight into neurodevelopmental factors associated with treatment resistance or act as early predictors of treatment resistance, which could allow prompt identification of refractory illness and timely interventions.

引用

页码：173 / 181

页数：9

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