Executive Impairment Predicts Schizophrenia Diagnosis and Treatment Status in Mid-Term Follow-Up of Early-Onset Psychosis

Objectives: Early-onset psychoses (EOP) vary considerably with regard to diagnostic stability and functional outcome. The aim of this study was the assessment of executive dysfunction as a predictor of outcome in EOP. Method: This was a retrospective cohort study. Twenty-five hospitalized patients with non-affective EOP were assessed with the Wisconsin Card Sorting Test (WCST) during the index admission. Associations with current diagnosis, further admissions, current treatment status and occupational and relationship outcome were analyzed in 6 years of follow-up. Results: The mean age at the index admission and the follow-up was 16.1 +/- 1.35 and 22.0 +/- 2.1 years, respectively. After discharge, almost all subjects (96%) at least briefly continued psychiatric treatment, and the majority of them (76%) were readmitted. Worse baseline WCST results were associated with a follow-up schizophrenia diagnosis, being a psychiatric in- or outpatient at the moment of follow-up assessment and receiving psychotropic medication. A low number of completed categories correlated with receiving a disability pension at the follow-up. Conclusion: In patients with EOP, baseline executive function impairment was associated with schizophrenia diagnosis and psychiatric treatment at the follow-up. The association between baseline results and psychiatric treatment may explain the limited effect of baseline impairment on follow-up occupational and relationship status. (C) 2014 S. Karger AG, Basel