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24.3 EIGHTEEN-YEAR COURSE OF COGNITIVE FUNCTIONING IN PSYCHOTIC DISORDERS: FINDINGS FROM THE SUFFOLK COUNTY MENTAL HEALTH LONGITUDINAL STUDY

BACKGROUND: Knowledge about the long-term cognitive course in psychotic disorders is limited. In this 18-year follow-up of participants of the Suffolk County project we report on the longitudinal course of cognitive performance in individuals with schizophrenia spectrum disorders, affective psychose...

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Autores principales: Anne-Kathrin, Fett, Velthorst, Eva, Reichenberg, Avi, Ruggero, Camilo, Callahan, Jennifer, Bromet, Evelyn J, Kotov, Roman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5887290/
http://dx.doi.org/10.1093/schbul/sby014.098
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author Anne-Kathrin, Fett
Velthorst, Eva
Reichenberg, Avi
Ruggero, Camilo
Callahan, Jennifer
Bromet, Evelyn J
Kotov, Roman
author_facet Anne-Kathrin, Fett
Velthorst, Eva
Reichenberg, Avi
Ruggero, Camilo
Callahan, Jennifer
Bromet, Evelyn J
Kotov, Roman
author_sort Anne-Kathrin, Fett
collection PubMed
description BACKGROUND: Knowledge about the long-term cognitive course in psychotic disorders is limited. In this 18-year follow-up of participants of the Suffolk County project we report on the longitudinal course of cognitive performance in individuals with schizophrenia spectrum disorders, affective psychoses and other psychoses. We investigate (i) change in functioning in 6 cognitive domains from 2-years to 20-years follow-up after first admission; (ii) 20-year performance and age-related differences in cognitive performance in patients relative to a never psychotic comparison group; and (iii) key predictors of clinically meaningful cognitive decline in patients. METHODS: Data came from the Suffolk County Mental Health Project, a prospective study of first-admission patients. Cognitive tests were administered 2 years (n = 399; schizophrenia spectrum: 285, affective psychoses: 226, other psychoses: 117) and 20 years (n = 240; 115, 92, and 34, respectively) after first admission, with 195 individuals completing cognitive tests at both time points. A never psychotic comparison group (N=260) was assessed at year 20. RESULTS: Individuals with schizophrenia spectrum disorders showed lower cognitive functioning than those with affective and other psychoses. Over time, patients declined in cognitive performance on almost all tests (d = 0.24 (range 0.12- 0.44)) with comparable magnitude across diagnoses. Longer duration of untreated psychosis and low childhood IQ were significantly associated with clinically relevant decline (>0.5SD) in general verbal ability and processing speed, but there were no robust predictors of cognitive decline across tests. Cross-sectional comparisons of patients to controls showed increasing impairments with age for general verbal ability, verbal fluency, and executive functioning. DISCUSSION: Our findings indicate that cognitive functioning in psychotic disorders continues to decline after the illness onset, that this decline is not specific to schizophrenia but present across psychotic disorders, and that, relative to never-psychotic individuals, impairments on some key-cognitive domains worsen with age. These results imply that cognitive treatment should not only include cognitive remediation but also prevention of age-related cognitive stagnation and/or decline.
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spelling pubmed-58872902018-04-11 24.3 EIGHTEEN-YEAR COURSE OF COGNITIVE FUNCTIONING IN PSYCHOTIC DISORDERS: FINDINGS FROM THE SUFFOLK COUNTY MENTAL HEALTH LONGITUDINAL STUDY Anne-Kathrin, Fett Velthorst, Eva Reichenberg, Avi Ruggero, Camilo Callahan, Jennifer Bromet, Evelyn J Kotov, Roman Schizophr Bull Abstracts BACKGROUND: Knowledge about the long-term cognitive course in psychotic disorders is limited. In this 18-year follow-up of participants of the Suffolk County project we report on the longitudinal course of cognitive performance in individuals with schizophrenia spectrum disorders, affective psychoses and other psychoses. We investigate (i) change in functioning in 6 cognitive domains from 2-years to 20-years follow-up after first admission; (ii) 20-year performance and age-related differences in cognitive performance in patients relative to a never psychotic comparison group; and (iii) key predictors of clinically meaningful cognitive decline in patients. METHODS: Data came from the Suffolk County Mental Health Project, a prospective study of first-admission patients. Cognitive tests were administered 2 years (n = 399; schizophrenia spectrum: 285, affective psychoses: 226, other psychoses: 117) and 20 years (n = 240; 115, 92, and 34, respectively) after first admission, with 195 individuals completing cognitive tests at both time points. A never psychotic comparison group (N=260) was assessed at year 20. RESULTS: Individuals with schizophrenia spectrum disorders showed lower cognitive functioning than those with affective and other psychoses. Over time, patients declined in cognitive performance on almost all tests (d = 0.24 (range 0.12- 0.44)) with comparable magnitude across diagnoses. Longer duration of untreated psychosis and low childhood IQ were significantly associated with clinically relevant decline (>0.5SD) in general verbal ability and processing speed, but there were no robust predictors of cognitive decline across tests. Cross-sectional comparisons of patients to controls showed increasing impairments with age for general verbal ability, verbal fluency, and executive functioning. DISCUSSION: Our findings indicate that cognitive functioning in psychotic disorders continues to decline after the illness onset, that this decline is not specific to schizophrenia but present across psychotic disorders, and that, relative to never-psychotic individuals, impairments on some key-cognitive domains worsen with age. These results imply that cognitive treatment should not only include cognitive remediation but also prevention of age-related cognitive stagnation and/or decline. Oxford University Press 2018-04 2018-04-01 /pmc/articles/PMC5887290/ http://dx.doi.org/10.1093/schbul/sby014.098 Text en © Maryland Psychiatric Research Center 2018. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Anne-Kathrin, Fett
Velthorst, Eva
Reichenberg, Avi
Ruggero, Camilo
Callahan, Jennifer
Bromet, Evelyn J
Kotov, Roman
24.3 EIGHTEEN-YEAR COURSE OF COGNITIVE FUNCTIONING IN PSYCHOTIC DISORDERS: FINDINGS FROM THE SUFFOLK COUNTY MENTAL HEALTH LONGITUDINAL STUDY
title 24.3 EIGHTEEN-YEAR COURSE OF COGNITIVE FUNCTIONING IN PSYCHOTIC DISORDERS: FINDINGS FROM THE SUFFOLK COUNTY MENTAL HEALTH LONGITUDINAL STUDY
title_full 24.3 EIGHTEEN-YEAR COURSE OF COGNITIVE FUNCTIONING IN PSYCHOTIC DISORDERS: FINDINGS FROM THE SUFFOLK COUNTY MENTAL HEALTH LONGITUDINAL STUDY
title_fullStr 24.3 EIGHTEEN-YEAR COURSE OF COGNITIVE FUNCTIONING IN PSYCHOTIC DISORDERS: FINDINGS FROM THE SUFFOLK COUNTY MENTAL HEALTH LONGITUDINAL STUDY
title_full_unstemmed 24.3 EIGHTEEN-YEAR COURSE OF COGNITIVE FUNCTIONING IN PSYCHOTIC DISORDERS: FINDINGS FROM THE SUFFOLK COUNTY MENTAL HEALTH LONGITUDINAL STUDY
title_short 24.3 EIGHTEEN-YEAR COURSE OF COGNITIVE FUNCTIONING IN PSYCHOTIC DISORDERS: FINDINGS FROM THE SUFFOLK COUNTY MENTAL HEALTH LONGITUDINAL STUDY
title_sort 24.3 eighteen-year course of cognitive functioning in psychotic disorders: findings from the suffolk county mental health longitudinal study
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5887290/
http://dx.doi.org/10.1093/schbul/sby014.098
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