Cargando…
Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia
BACKGROUND–OBJECTIVE: Prevalence data of cognitive impairment in Schizophrenia based on large population samples are scarce. Our goal is to relate cognition and functional outcomes, and estimate prevalence of cognitive impairment in a large sample of schizophrenia outpatients treated with second-gen...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779297/ https://www.ncbi.nlm.nih.gov/pubmed/29379764 http://dx.doi.org/10.1016/j.scog.2015.03.002 |
_version_ | 1783294506754375680 |
---|---|
author | Zaragoza Domingo, Silvia Bobes, Julio García-Portilla, Maria-Paz Morralla, Claudia |
author_facet | Zaragoza Domingo, Silvia Bobes, Julio García-Portilla, Maria-Paz Morralla, Claudia |
author_sort | Zaragoza Domingo, Silvia |
collection | PubMed |
description | BACKGROUND–OBJECTIVE: Prevalence data of cognitive impairment in Schizophrenia based on large population samples are scarce. Our goal is to relate cognition and functional outcomes, and estimate prevalence of cognitive impairment in a large sample of schizophrenia outpatients treated with second-generation antipsychotics. METHOD: A cross-sectional outpatient evaluation conducted during follow-up visits. Selection criteria included six-months stable treatment. The brief battery, EPICOG-SCH, covered four cognitive domains related to functional outcomes: working memory (WAIS-III-Letter-Number-Sequencing), executive function (Category Fluency Test; CFT), verbal memory (WMS-III-Logical-Memory), and information processing speed (Digit-Symbol-Coding and CFT). Clinical severity and functional impairment were assessed with CGI-SCH and WHO DAS-S. Impairment prevalence was calculated at ≤ 1.5 SD. RESULTS: Among patients recruited (n = 848) in 234 participating centers, 672 were under 6-month treatment. 61.5% (n = 413) reported cognitive impairment according to CGI-SCH Cognitive Subscale. Estimated prevalences were 85.9% (95% CI 85.6–86.2%) CFT-Fruits; 68.3% (95% CI 67.8–68.8%) CFT-Animals; 38.1% (95% CI 37.5–38.3%) Digit-Symbol-Coding; 24.8% (95% CI 24.1–25.5%) Verbal Memory-Units; 20.9% (95% CI 20.2–21.6%) Letter-Number Sequencing; 11.7% (95% CI 11.0–12.4%) Verbal Memory-Items. Negative and Depressive symptoms, Deficit Syndrome, and functional disability were related to poor performance. Functional disability was predicted by CGI-SCH-Overall severity (OR = 1.34635, p < 0.0001), CGI-SCH-Negative Symptoms (OR = 0.75540, p < 0.0001), working memory (Letter-Number-Sequencing) (OR = − 0.16442, p = 0.0004) and the time-course (OR = 0.05083, p = 0.0094), explaining 47% of the observed variability. CONCLUSION: Most prevalent impairments were on executive function and processing speed domains; however, working memory showed the strongest relationship to functional disability. Monitoring cognitive function during follow up is critical to understand patient’s everyday functional capacity. |
format | Online Article Text |
id | pubmed-5779297 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-57792972018-01-29 Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia Zaragoza Domingo, Silvia Bobes, Julio García-Portilla, Maria-Paz Morralla, Claudia Schizophr Res Cogn Article BACKGROUND–OBJECTIVE: Prevalence data of cognitive impairment in Schizophrenia based on large population samples are scarce. Our goal is to relate cognition and functional outcomes, and estimate prevalence of cognitive impairment in a large sample of schizophrenia outpatients treated with second-generation antipsychotics. METHOD: A cross-sectional outpatient evaluation conducted during follow-up visits. Selection criteria included six-months stable treatment. The brief battery, EPICOG-SCH, covered four cognitive domains related to functional outcomes: working memory (WAIS-III-Letter-Number-Sequencing), executive function (Category Fluency Test; CFT), verbal memory (WMS-III-Logical-Memory), and information processing speed (Digit-Symbol-Coding and CFT). Clinical severity and functional impairment were assessed with CGI-SCH and WHO DAS-S. Impairment prevalence was calculated at ≤ 1.5 SD. RESULTS: Among patients recruited (n = 848) in 234 participating centers, 672 were under 6-month treatment. 61.5% (n = 413) reported cognitive impairment according to CGI-SCH Cognitive Subscale. Estimated prevalences were 85.9% (95% CI 85.6–86.2%) CFT-Fruits; 68.3% (95% CI 67.8–68.8%) CFT-Animals; 38.1% (95% CI 37.5–38.3%) Digit-Symbol-Coding; 24.8% (95% CI 24.1–25.5%) Verbal Memory-Units; 20.9% (95% CI 20.2–21.6%) Letter-Number Sequencing; 11.7% (95% CI 11.0–12.4%) Verbal Memory-Items. Negative and Depressive symptoms, Deficit Syndrome, and functional disability were related to poor performance. Functional disability was predicted by CGI-SCH-Overall severity (OR = 1.34635, p < 0.0001), CGI-SCH-Negative Symptoms (OR = 0.75540, p < 0.0001), working memory (Letter-Number-Sequencing) (OR = − 0.16442, p = 0.0004) and the time-course (OR = 0.05083, p = 0.0094), explaining 47% of the observed variability. CONCLUSION: Most prevalent impairments were on executive function and processing speed domains; however, working memory showed the strongest relationship to functional disability. Monitoring cognitive function during follow up is critical to understand patient’s everyday functional capacity. Elsevier 2015-04-14 /pmc/articles/PMC5779297/ /pubmed/29379764 http://dx.doi.org/10.1016/j.scog.2015.03.002 Text en © 2015 The Authors. Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Zaragoza Domingo, Silvia Bobes, Julio García-Portilla, Maria-Paz Morralla, Claudia Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia |
title | Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia |
title_full | Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia |
title_fullStr | Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia |
title_full_unstemmed | Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia |
title_short | Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia |
title_sort | cognitive performance associated to functional outcomes in stable outpatients with schizophrenia |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779297/ https://www.ncbi.nlm.nih.gov/pubmed/29379764 http://dx.doi.org/10.1016/j.scog.2015.03.002 |
work_keys_str_mv | AT zaragozadomingosilvia cognitiveperformanceassociatedtofunctionaloutcomesinstableoutpatientswithschizophrenia AT bobesjulio cognitiveperformanceassociatedtofunctionaloutcomesinstableoutpatientswithschizophrenia AT garciaportillamariapaz cognitiveperformanceassociatedtofunctionaloutcomesinstableoutpatientswithschizophrenia AT morrallaclaudia cognitiveperformanceassociatedtofunctionaloutcomesinstableoutpatientswithschizophrenia AT cognitiveperformanceassociatedtofunctionaloutcomesinstableoutpatientswithschizophrenia |