Cognitive markers of short-term clinical outcome in first-episode psychosis

Abstract

Background Outcome from psychotic disorders is heterogeneous with poorer outcomes frequently identified too late to be influenced. Symptomatic ratings at 1 or more years following initiation of treatment have been related to cognition in firstepisode psychosis. However, the relationship between cognition and early outcome remains unclear. Aims To determine whether specific cognitive domains could identify poor short-term outcome among individuals with first-episode psychosis. Method One hundred and fifty-one individuals with first-episode psychosis were divided into two groups based on 6-month clinical data after the initiation of treatment. Six cognitive domains were compared among 78 participants with poor outcomes, 73 with good outcomes and 31 healthy controls. Results Lower performance on verbal memory (z-scores: poor outcome=-1.3 (s.d.=1.1); good outcome=-0.8 (s.d.=0.9); P=0.001) and working memory (poor outcome=-1.0 (s.d.=1.2); good outcome=-0.4 (s.d.=0.9); P=0.003) identified individuals with first-episode psychosis with a poor outcome after 6 months of treatment. Conclusions The early identification of those individuals with first-episode psychosis with a poor clinical outcome may encourage clinicians to pay special attention to them in the form of alternative pharmacological and psychological treatments for a more favourable outcome in the long term.