Correlates of cognitive impairment in first episode schizophrenia: The EUFEST study
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.
cDepartment of Psychiatry, Rudolf Magnus Institute of Neuroscience University Medical Centre Utrecht, Utrecht, The Netherlands
dDepartment of Psychiatry, Central Military Hospital, Bucharest, Romania
eDepartment of Adult Psychiatry, University of Medical Sciences, Poznan, Poland
fDepartment and Clinic of Psychiatry, Charles University Medical School and Faculty Hospital, Hradec Králové, Czech Republic
gCentre Esquirol, Centre Hospitalier Universitaire, Caen, France
hInstitute of Psychiatry and Mental Health, Hospital Clínico San Carlos, Madrid, Spain
iUniversity Psychiatric Centre, Campus St. Jozef Kortenberg, Katholieke Universiteit Leuven, Leuven, Belgium
jDepartment and Clinic of Psychiatry, University Hospital of Neurology and Psychiatry St Naum, Sofia, Bulgaria
kDepartment of Biological Psychiatry, Medical University Innsbruck, Innsbruck, Austria
Corresponding author. Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, 80138 Naples, Italy. Tel.: +39 081 5666504; fax: +39 081 5666523.
1Management 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).
ABSTRACT