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Neurocognitive functioning in patients with first-episode schizophrenia

Results of a prospective 5-year follow-up study

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Abstract

To assess the course of neuropsychological (NP) impairment in schizophrenia, 71 patients with first episode (FE) schizophrenia and 71 healthy controls were given a comprehensive battery of NP tests at index assessment, after a 2-year and after a 5-year follow-up period. By means of the z-score standardization, summary scores for verbal intelligence (VBI), spatial organisation (SPT), verbal fluency (VBF), Verbal learning (VBL), semantic memory (SEM), visual memory (VIM), delay/retention rate (DEL), short-term memory (STM), visuomotor processing and attention (VSM) and abstraction/flexibility (ABS) were constructed. FE schizophrenia patients showed a worse performance compared to controls in all areas investigated, most pronounced in VSM, SEM and VBL. In the majority of cognitive domains, an improvement was found over the 5-year follow-up period without differences between the two groups. However, in VBF patients slightly deteriorated whilst controls improved and in memory functions patients improved less compared to controls. When controlling for relevant confounders, neither conventional nor atypical neuroleptics showed a deleterious influence on NP performance, except on VBF. Our data suggest that NP impairment is already present at the onset of the illness and remains stable over the early course of schizophrenia.

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References

  1. Haas GL, Keshavan MS, Dickey JA, Sweeney JA, Dew MA (2001) Patterns of premorbid psychosocial dysmaturation predict neurocognitive deficits in working memory and psychomotor speed. Schizophr Res 49:108–114

    Google Scholar 

  2. Rund BR, Melle I, Friis S, Larsen TKL, Midboe LJ, Opjordsmoen S, Simonsen E, Vaglum P, McGlashan T (2004) Neurocognitive dysfunction in first-episode psychosis: correlation with symptoms, premorbid adjustment, and duration of untreated psychosis. Am J Psychiatry 161:466–472

    Article  PubMed  Google Scholar 

  3. Hoff AL, Sakuma M, Wieneke M, Horon R, Kushner M, DeLisi LE (1999) Longitudinal neuropsychological follow-up study of patients with fist-episode schizophrenia. Am J Psychiatry 156:1336–1341

    PubMed  CAS  Google Scholar 

  4. Censits DM, Ragland JD, Gur RC, Gur RE (1997) Neuropsychological evidence supporting a neurodevelopmental model of schizophrenia: a longitudinal study. Schizophr Res 24:289–298

    Article  PubMed  CAS  Google Scholar 

  5. Hill SK, Schuepach D, Herbener ES, Keshavan MS, Sweeney JA (2004) Pretreatment and longitudinal studies of neuropsychological deficits in antipsychotic-naive patients with schizophrenia. Schizophr Res 68:49–63

    Article  PubMed  Google Scholar 

  6. Bilder RM, Goldman RS, Robinson D, Reiter G, Bell L, Bates JA, Pappadopulos E, Wilson DF, Alvir JMJ, Woerner MG, Geisler S, Kane JM, Lieberman JA (2000) Neuropsychology of first-episode schizophrenia: initial characterization and clinical correlates. Am J Psychiatry 157:549–559

    Article  PubMed  CAS  Google Scholar 

  7. Albus M, Hubmann W, Mohr F, Scherer J, Sobizack N, Franz U, Hecht S, Borrmann M, Wahlheim C (1997) Are there gender differences in neuropsychological performance in patients with first-episode schizophrenia? Schiz Res 28:39–50

    Article  CAS  Google Scholar 

  8. Albus M, Hubmann W, Scherer J, Dreikorn B, Hecht S, Sobizack N, Mohr F (2002) A prospective 2-year follow-up study of neurocognitive functioning in patients with first-episode schizophrenia. Eur Arch Psychiatry Clin Neurosci 252:262–267

    Article  PubMed  Google Scholar 

  9. Saykin AK, Shtasel DL, Gur RE, Kester DB, Mozley LH, Stafini AKP, Gur RC (1994) Neuropsychological deficits in neuroleptic naïve patients with first-episode schizophrenia. Arch Gen Psychiatry 51:124–131

    PubMed  CAS  Google Scholar 

  10. Brazo P, Marie RM, Halbecq I, Benali K, Segard L, Delamillieure P, Langlois-Thery S, Van Der Elst A, Thibaut F, Petit M, Dollfus S (2002) Cognitive patterns in subtypes of schizophrenia. Eur Psychiatry 17:155–162

    Article  PubMed  CAS  Google Scholar 

  11. Malla AK, Norman RM, Manchanda R, Townsend L (2002) Symptoms, cognition, treatment adherence and functional outcome in first-episode psychosis. Psychol Med 32:111–119

    Article  Google Scholar 

  12. Heydebrand G, Weiser M, Rabinowitz J, Hoff AL, DeLisi LE, Csernansky JG (2004) Correlates of cognitive deficits in first episode schizophrenia. Schiz Res 68:1–9

    Article  Google Scholar 

  13. Milev P, Ho B-C, Arndt S, Andreasen NC (2005) Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: a longitudinal first-episode study with 7-year follow-up. Am J Psychiatry 162:495–506

    Article  PubMed  Google Scholar 

  14. Gold S, Arnst S, Nopoulos P, O’Leary DA, Andreasen NC (1999) Longitudinal study of cognitive function I – first-episode and recent-onset schizophrenia. Am J Psychiatry 156:1342–1348

    PubMed  CAS  Google Scholar 

  15. Schuepbach D, Keshavan MS, Kmiec JA, Sweeney JA (2002) Negative symptom resolution and improvements in specific cognitive deficits after acute treatment in first-episode schizophrenia. Schizophr Res 53:249–261

    Article  PubMed  Google Scholar 

  16. Keefe RSE, Silva SG, Perkins DP, Lieberman JA (1999) The effects of atypical antipsychotic drugs on neurocognitive impairment in schizophrenia: a review and meta-analysis. Schizophr Bull 25:201–221

    PubMed  CAS  Google Scholar 

  17. Purdon SE (2000) Measuring neuropsychological change in schizophrenia with novel antipsychotic medications. J Psychiatry Neurosci 25:108–116

    PubMed  CAS  Google Scholar 

  18. Bilder RM, Goldman RS, Volavka J, Czobor P, Hoptman M, Sheitm B, Lindenmayer JP, Citrome L, McEvoy J, Kunz M, Chakos M, Coo TB, Horowitz TL, Lieberman JA (2002) Neurocognitive effects of clozapine, olanzapine, risperidone, haloperidol in patients with chronic schizophrenia or schizoaffective disorder. Am J Psychiatry 159:1018–1028

    Article  PubMed  Google Scholar 

  19. Purdon SE, Labelle A, Boulay L (2001) Neuropsychological change in schizophrenia after 6 weeks of clozapine. Schizophr Res 48:57–67

    Article  PubMed  CAS  Google Scholar 

  20. Meltzer HY, McGurk SR (1999) The effects of clozapine, risperidone, and olanzapine on cognitive function in schizophrenia. Schizophr Bull 25:233–255

    PubMed  CAS  Google Scholar 

  21. Harvey PD, Keefe RSE (2001) Studies of cognitive change with treatment in schizophrenia. Am J Psychiatry 158:176–184

    Article  PubMed  CAS  Google Scholar 

  22. Cirillo MA, Seidman LJ (2003) Verbal declarative memory dysfunction in schizophrenia: from clinical assessment to genetics and brain mechanisms. Neuropsychol Rev 13(2):43–77

    Article  PubMed  Google Scholar 

  23. Mishara AL, Goldberg TE (2004) A meta-analysis and critical review of the effects of conventional neuroleptic treatment on cognition in schizophrenia: Opening a closed book. Biol Psychiatry 55:1013–1022

    Article  PubMed  CAS  Google Scholar 

  24. Rollnik JD, Borsutzky M, Huber TJ, Mogk H, Seifert J, Emrich HM, Schneider U (2002) Short-term cognitive improvement in schizophrenics treated with typical and atypical neuroleptics. Neuropsychobiology 45:74–80

    Article  PubMed  CAS  Google Scholar 

  25. Green MF, Marder SR, Glynn SM, McGurk SR, Wirshin WC, Wirshin DA, Liberman RP, Mintz J (2002) The neurocognitive effects of low-dose haloperidol: a two-year comparison with risperidone. Biol Psychiatry 15:969–971

    Google Scholar 

  26. Spitzer RL, Williams JBW, Gibbon M (1987) Structured clinical interview for DSM-III-R (SCID). Biometrics Research Department, New York State Psychiatric Institute, New York

    Google Scholar 

  27. First MB, Spitzer RL, Gibbon M, Williams JBW (1995) Structured clinical interview for DSM-IV axis I disorders-patient edition (SCID I/P, version 2.0). Biometrics Research Department, New York State Psychiatric Institute

  28. Overall JE, Gorham DR (1976) BPRS. Brief psychiatric rating scale. In: Guy W (ed) ECDEU assessment manual for psychopharmacology. Rev Ed, Rockville, Maryland, pp 157–169

    Google Scholar 

  29. Hamilton MA (1976) Hamilton depression scale. In: Guy W (ed) ECDEU assessment manual for psychopharmacology. Rev Ed, Rockville, Maryland, pp 179–192

    Google Scholar 

  30. Guy W, Bonato RR (1976) CGI. Clinical global impressions. Manual for the EDCEU assessment battery. Rev Ed, Chevy Chase, Maryland, pp 12-1–12-6

    Google Scholar 

  31. Andreasen NC (1989) Scale for the assessment of negative symptoms (SANS). Br J Psychiatry 155:53–58

    Google Scholar 

  32. Kay SR, Fiszbein A, Opler LA (1987) The positive, negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 13:261–276

    PubMed  CAS  Google Scholar 

  33. Kirkpatrick B, Buchanan RW, McKenney PD, Alphs LD, Carpenter WT (1989) The schedule for the deficit syndrome: an instrument for research in schizophrenia. Psychiatr Res 30:119–124

    Article  CAS  Google Scholar 

  34. Albus M, Hubmann W, Ehrenberg C, Forcht U, Mohr F, Sobizack N, Wahlheim C, Hecht S (1996) Neuropsychological impairment in first-episode and chronic schizophrenia patients. Eur Arch Psychiatry Clin Neurosci 246:249–255

    Article  PubMed  CAS  Google Scholar 

  35. Wechsler D (1981) Manual for the Wechsler adult intelligence scale – revised. Psychological Corporation, San Antonio, TX

    Google Scholar 

  36. Mattis S (1976) Mental status examination for organic mental syndrome in the elderly patient. In: Bellack L, Karasu T (eds) Geriatric psychiatry. Grune and Stratton, New York

    Google Scholar 

  37. Horn W (1983) Leistungsprüfsystem L-P-S. Hogrefe, Göttingen

    Google Scholar 

  38. Delis DC, Kramer JH, Kaplan E, Ober BA (1987) California verbal learning test. Psychological Corporation, New York

    Google Scholar 

  39. Wechsler D (1987) Wechsler memory scale revised. The Psychological Corporation, New York

    Google Scholar 

  40. Daneman M, Carpenter PA (1980) Individual differences in working memory and reading. J Verb Learn Verb Behav 19:450–466

    Article  Google Scholar 

  41. Reitan RM (1958) Validity of the trailmaking test as an indication of organic brain damage. Percept Motor Skills 8:271–276

    Article  Google Scholar 

  42. Stroop JR (1989) Studies of interference in serial verbal reactions. J Experim Psychol 89:367–380

    Google Scholar 

  43. Heaton RK (1981) Wisconsin card sorting test manual. Psychological Assessment Resources, Odessa, FL

    Google Scholar 

  44. Kremen WS, Seidman LJ, Faraone SV, Toomey R, Tsuang MT (2004) Heterogeneity of schizophrenia: a study of individual neuropsychological profiles. Schizophr Res 71:307–321

    Article  PubMed  Google Scholar 

  45. Peterson BS, Skudlarski P, Gatenby JC, Zhang H, Anderson AW, Gore JC (1999) A fMRI study of Stroop word-color interference: evidence for cingulate subregions subserving multiple distributed attentional systems. Biol Psychiatry 45:1237–1258

    Article  PubMed  CAS  Google Scholar 

  46. Kremen WS, Seidman LJ, Faraone SV, Pepple JR, Lyons MJ, Tsuan MT (1996) The “3Rs” and neuropsychological function in schizophrenia: an empirical test of the matching fallacy. Neuropsychology 10:22–31

    Article  Google Scholar 

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Acknowledgement

This study was supported by a grant from the German Research Foundation (Al 230/3-1; 3-2; 3-3).

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Authors and Affiliations

  1. District Hospital Haar, Vockestr. 72, 85540, Haar, Germany

    Margot Albus, Werner Hubmann, Fritz Mohr, Susanne Hecht & Petra Hinterberger-Weber

  2. Department of Statistics, Ludwig-Maximilians-Universität, Akademiestr. 1, 80799, Munich, Germany

    Nichi-Niels Seitz & Helmut Küchenhoff

Authors
  1. Margot Albus
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  2. Werner Hubmann
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  3. Fritz Mohr
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  4. Susanne Hecht
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  7. Helmut Küchenhoff
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Correspondence to Margot Albus.

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Albus, M., Hubmann, W., Mohr, F. et al. Neurocognitive functioning in patients with first-episode schizophrenia. Eur Arch Psychiatry Clin Neurosci 256, 442–451 (2006). https://doi.org/10.1007/s00406-006-0667-1

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  • DOI: https://doi.org/10.1007/s00406-006-0667-1

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