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Impacts of duration of untreated psychosis on cognition and negative symptoms in first-episode schizophrenia: a 3-year prospective follow-up study.
Psychol Med 2013; 43(9):1883-93PM

Abstract

BACKGROUND

Cognitive impairment is a core feature of schizophrenia. Its relationship with duration of untreated psychosis (DUP), a potentially malleable prognostic factor, has been less studied, with inconsistent findings being observed in the literature. Previous research investigating such a relationship was mostly cross-sectional and none of those prospective studies had a follow-up duration beyond 2 years. Method A total of 93 Hong Kong Chinese aged 18 to 55 years presenting with first-episode schizophrenia-spectrum disorder were studied. DUP and pre-morbid adjustment were measured using a structured interview incorporating multiple sources of information. Psychopathological evaluation was administered at intake, after clinical stabilization of the first psychotic episode, and at 12, 24 and 36 months. Cognitive functions were measured at clinical stabilization, and at 12, 24 and 36 months.

RESULTS

DUP exerted differential effects on various cognitive domains, with memory deficits being the most related to DUP even when potential confounders including pre-morbid adjustment and sex were adjusted. Prolonged DUP was associated with more severe impairment in visual memory at clinical stabilization and verbal memory at 24 and 36 months. Further, patients with a long DUP were found to have worse outcomes on negative symptoms at 36 months. The effects of DUP on verbal memory remained significant even when negative symptoms were taken into consideration.

CONCLUSIONS

Our findings provided further supportive evidence that delayed treatment to first-episode psychosis is associated with poorer cognitive and clinical outcomes. In addition, DUP may specifically affect memory function and its adverse impact on verbal memory may only become evident at a later stage of the recovery process.

Authors+Show Affiliations

Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong. changwc@hku.hkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23217676

Citation

Chang, W C., et al. "Impacts of Duration of Untreated Psychosis On Cognition and Negative Symptoms in First-episode Schizophrenia: a 3-year Prospective Follow-up Study." Psychological Medicine, vol. 43, no. 9, 2013, pp. 1883-93.
Chang WC, Hui CL, Tang JY, et al. Impacts of duration of untreated psychosis on cognition and negative symptoms in first-episode schizophrenia: a 3-year prospective follow-up study. Psychol Med. 2013;43(9):1883-93.
Chang, W. C., Hui, C. L., Tang, J. Y., Wong, G. H., Chan, S. K., Lee, E. H., & Chen, E. Y. (2013). Impacts of duration of untreated psychosis on cognition and negative symptoms in first-episode schizophrenia: a 3-year prospective follow-up study. Psychological Medicine, 43(9), pp. 1883-93. doi:10.1017/S0033291712002838.
Chang WC, et al. Impacts of Duration of Untreated Psychosis On Cognition and Negative Symptoms in First-episode Schizophrenia: a 3-year Prospective Follow-up Study. Psychol Med. 2013;43(9):1883-93. PubMed PMID: 23217676.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impacts of duration of untreated psychosis on cognition and negative symptoms in first-episode schizophrenia: a 3-year prospective follow-up study. AU - Chang,W C, AU - Hui,C L M, AU - Tang,J Y M, AU - Wong,G H Y, AU - Chan,S K W, AU - Lee,E H M, AU - Chen,E Y H, Y1 - 2012/12/07/ PY - 2012/12/11/entrez PY - 2012/12/12/pubmed PY - 2014/4/4/medline SP - 1883 EP - 93 JF - Psychological medicine JO - Psychol Med VL - 43 IS - 9 N2 - BACKGROUND: Cognitive impairment is a core feature of schizophrenia. Its relationship with duration of untreated psychosis (DUP), a potentially malleable prognostic factor, has been less studied, with inconsistent findings being observed in the literature. Previous research investigating such a relationship was mostly cross-sectional and none of those prospective studies had a follow-up duration beyond 2 years. Method A total of 93 Hong Kong Chinese aged 18 to 55 years presenting with first-episode schizophrenia-spectrum disorder were studied. DUP and pre-morbid adjustment were measured using a structured interview incorporating multiple sources of information. Psychopathological evaluation was administered at intake, after clinical stabilization of the first psychotic episode, and at 12, 24 and 36 months. Cognitive functions were measured at clinical stabilization, and at 12, 24 and 36 months. RESULTS: DUP exerted differential effects on various cognitive domains, with memory deficits being the most related to DUP even when potential confounders including pre-morbid adjustment and sex were adjusted. Prolonged DUP was associated with more severe impairment in visual memory at clinical stabilization and verbal memory at 24 and 36 months. Further, patients with a long DUP were found to have worse outcomes on negative symptoms at 36 months. The effects of DUP on verbal memory remained significant even when negative symptoms were taken into consideration. CONCLUSIONS: Our findings provided further supportive evidence that delayed treatment to first-episode psychosis is associated with poorer cognitive and clinical outcomes. In addition, DUP may specifically affect memory function and its adverse impact on verbal memory may only become evident at a later stage of the recovery process. SN - 1469-8978 UR - https://www.unboundmedicine.com/medline/citation/23217676/Impacts_of_duration_of_untreated_psychosis_on_cognition_and_negative_symptoms_in_first_episode_schizophrenia:_a_3_year_prospective_follow_up_study_ L2 - https://www.cambridge.org/core/product/identifier/S0033291712002838/type/journal_article DB - PRIME DP - Unbound Medicine ER -