Correlates of cognitive impairment in first episode schizophrenia: The EUFEST study

Galderisi, Silvana; Davidson, Michael; Kahn, René S.; Mucci, Armida; Boter, Han; Gheorghe, Mihai D.; Rybakowski, Janusz K.; Libiger, Jan; Dollfus, Sonia; López-Ibor, Juan J.; Peuskens, Joseph; Hranov, Luchezar G.; Fleischhacker, Wolfgang W.; EUFEST group,

doi:10.1016/j.schres.2009.09.022

« Previous Next »Schizophrenia Research
Volume 115, Issue 2 , Pages 104-114, December 2009

Correlates of cognitive impairment in first episode schizophrenia: The EUFEST study

Silvana Galderisi
- Department of Psychiatry, University of Naples SUN, Naples, Italy
- Corresponding author. Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, 80138 Naples, Italy. Tel.: +39 081 5666504; fax: +39 081 5666523.
Michael Davidson
- Sheba Medical Center, Tel Hashomer, Israel
René S. Kahn
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience University Medical Centre Utrecht, Utrecht, The Netherlands
Armida Mucci
- Department of Psychiatry, University of Naples SUN, Naples, Italy
Han Boter
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience University Medical Centre Utrecht, Utrecht, The Netherlands
Mihai D. Gheorghe
- Department of Psychiatry, Central Military Hospital, Bucharest, Romania
Janusz K. Rybakowski
- Department of Adult Psychiatry, University of Medical Sciences, Poznan, Poland
Jan Libiger
- Department and Clinic of Psychiatry, Charles University Medical School and Faculty Hospital, Hradec Králové, Czech Republic
Sonia Dollfus
- Centre Esquirol, Centre Hospitalier Universitaire, Caen, France
Juan J. López-Ibor
- Institute of Psychiatry and Mental Health, Hospital Clínico San Carlos, Madrid, Spain
Joseph Peuskens
- University Psychiatric Centre, Campus St. Jozef Kortenberg, Katholieke Universiteit Leuven, Leuven, Belgium
Luchezar G. Hranov
- Department and Clinic of Psychiatry, University Hospital of Neurology and Psychiatry St Naum, Sofia, Bulgaria
Wolfgang W. Fleischhacker
- Department of Biological Psychiatry, Medical University Innsbruck, Innsbruck, Austria
EUFEST group
- Management group: R S Kahn, WW Fleischhacker, H Boter, C Brugman, H Burger, D E Grobbee, M C Hafkamp, I P M Keet, K Nijssen. Steering Committee: R S Kahn, WW Fleischhacker, H Boter, I P M Keet, C Brugman, M Davidson, S Dollfus, W Gaebel, S Galderisi, M Gheorghe, I Gonen, D E Grobbee, L G Hranov, M Hummer, J Libiger, N Lindefors, JJ López-Ibor, K Nijssen, J Peuskens, A Riecher-Rössler, JK Rybakowski, G Sedvall, M v Wilmsdorff. Office manager: P C Ywema. Julius Centre Study Team: data management—N Boekema, H den Breeijen, M van den Haak, P Huizinga, R Veen; project managers—C Brugman, M C Hafkamp, KM Nijssen; site monitoring—P Berackova, A Blizanowska, C Brugman, M C Hafkamp, T Huizinga, H van Gelderen, M Gordat, S Lorteau, G Makhanlal, H Moqadar. Tangent Data Study Team (co-monitoring Romania): I Gonen, A Mihailescu, R Radici, C Zus. Participating investigators (CC=Country coordinator; SC=site coordinator), centres, and countries: Austria—M Hummer (CC and SC Innsbruck), M Muhlbacher (SC Salzburg), H Widmoser (SC Hall in Tirol); Belgium—J Peuskens (CC), J Hulselmans (SC Antwerpen), C Mertens (SC Gent),E Thijs (SC Kortenberg); Bulgaria—L G Hranov (CC and SC Sofi a),S Georgiev (SC Plovdiv), L Sayan (SC Bourgas); Czech Republic—J Libiger (CC and SC Hradec Kràlové, E Češkovà (SC Brno), D Seifertovà (SC Praha-Bohnice); France: S Dollfus (CC and SC Caen I), G Allio (SC Rouen), B Chabot (SC Caen II), A Navarre Coulaud (SC Dieppe), P Thomas (SC Lille); Germany—W Gaebel (CC), M Krebs (SC Berlin), R Lencer (SC L・eck), K Leopold (SC Berlin), T Wobrock (SC Homburg); Israel—M Davidson (CC), Y Abramovitch (SC Beer-Yaakov), D Amital (SC Ness Ziona), A Caspi (SC Ramat Gan), A Kaplan (SC Beer Sheva), I Treves (SC Shalvata), P Zipris (SC Pardessiya); Italy—S Galderisi (CC), M Casacchia (SC L'Aquila), M Mauri (SC Milano II), A Mucci (SC Naples); Netherlands—H Boter (CC and SC Utrecht), I P M Keet (CC and SC Utrecht); Poland—JK Rybakowski (CC and SC Poznan), M Jarema (SC Warsaw), M Masiak (SC Lublin), J Rabe-Jablonska (SC Lodz); Romania—M Gheorghe (CC), V Burtea (SC Brasov), P Boisteanu (SC Iasi), C Friedman (SC Constanta), M Ienciu (SC Timisoara), A Ionescu (SC Buzau), I Miclutia (SC Cluj), T Mihai (SC Tulcea), D Prelipceanu (SC Bucuresti II), T Udistroiu (SC Craiova), D Vasile (SC Bucuresti I); Spain—JJ López-Ibor (CC), JL Carrasco (SC Madrid); Sweden—N Lindefors (CC and SC Stockholm), G Sedvall (CC), F A Wiesel (SC Uppsala); Switzerland—A Riecher-Rössler (CC), U Gschwandtner (SC Basel).

Received 8 March 2009; received in revised form 17 September 2009; accepted 21 September 2009. published online 12 October 2009.

Abstract

Background

Profile and correlates of cognitive deficits in first episode (FE) schizophrenia patients are still debated. The present study is aimed to clarify in a large sample of FE patients the extent of impairment in key cognitive domains and its relationships with demographic and clinical variables.

Method

The European First Episode Schizophrenia Trial collected demographic, clinical and neurocognitive baseline data in 498 FE patients with minimal or no prior exposure to antipsychotics. Two-hundred-twenty healthy subjects (HS) were also evaluated. Neurocognitive assessment included the Rey Auditory Verbal Learning Test; Trail Making A and B, Purdue Pegboard and Digit-Symbol Coding.

Results

Patients performed worse than HS on all tests (effect sizes from −0.88 to −1.73). Correlations with psychopathological dimensions were weak and involved reality distortion and disorganization. The duration of untreated psychosis (DUP) was not associated with cognitive impairment. Subjects living alone had a better neurocognitive performance, while the occupation status did not reveal any association with cognition.

Conclusions

A moderate/severe impairment of processing speed, motor dexterity, verbal memory and cognitive flexibility was found in the largest sample of FE patients analyzed so far. The impairment was largely independent from psychopathology and not associated with DUP.

Keywords: Cognition, Neuropsychology, Psychopathological dimensions, Antipsychotics, Duration of untreated psychosis, Psychosis