ABSTRACT
Cognitive dysfunctions are critical determinants of the quality of life and functionality in schizophrenia. Whether the cognitive deficits present at an early stage, are static or change across one's lifespan is still under debate. This study aims to investigate the long-term (3 years) course of cognitive deficits in a large and representative cohort of first episode schizophrenia spectrum patients (N=155),and evaluate their influence on disability. In addition, a healthy control sample (N=43) was also studied for comparison. This study evaluates the performance of patients and controls in a battery of cognitive assessments using baseline, 1-year and 3-year follow-up designs. The results show that, although cognitively outperformed by the controls at any time, the cognitive performance of the patients improved similar to the controls in all cognitive functions except verbal and visual memory. Even though the course of cognitive performance across the sample as a whole was stable, the subgroup of patients who experienced a cognitive decline had worse functionality and lesser amelioration of negative symptoms. Overall, there is no significant deterioration in the cognitive function in a group of first episode schizophrenia spectrum disorder patients, with the possible exception of tasks that were associated with episodic memory. However, patients whose cognitive performance demonstrated a declining trend may present with a poorer progression in terms of clinical and disability variables.
Subject(s)
Cognition Disorders/etiology , Schizophrenia/complications , Schizophrenic Psychology , Adolescent , Adult , Aged , Analysis of Variance , Cognition Disorders/diagnosis , Cohort Studies , Disease Progression , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Psychiatric Status Rating Scales , Time Factors , Verbal Learning , Young AdultABSTRACT
Introducción. La disminución de la velocidad de procesamiento parece ser una característica neuropsicológica prototípica en la esclerosis múltiple (EM). Sin embargo, el impacto de los frecuentes síntomas depresivos de estos pacientes sobre la velocidad de procesamiento aún no se ha definido con precisión, debido a algunas limitaciones metodológicas presentes en la mayoría de los estudios previos. Sujetos y métodos. Cuarenta y dos pacientes con EM remitente recurrente, 20 con síntomas depresivos (inventario de depresión de Beck > 13) y 22 sin ellos, fueron comparados con 24 controles sanos en tests neuropsicológicos de velocidad de procesamiento -Symbol Digit Modality Test (SDMT), test de Stroop, Trail Making Test (TMT) y Paced Auditory Serial Addition Test-batería neuropsicológica breve (PASAT-BNB)-. Resultados. Los pacientes con EM sin síntomas depresivos realizaron significativamente peor que los controles los tests de Stroop -palabra (P), color (C) y palabra-color (PC)- y PASAT-BNB (tiempo de ejecución), mientras que los pacientes con síntomas depresivos obtuvieron puntuaciones significativamente peores que los controles sanos en Stroop (P, C y PC), SDMT, TMT (A, B y B-A) y PASAT-BNB (tiempo de ejecución y errores). La ejecución de los pacientes con EM y síntomas depresivos fue significativamente peor que la de los pacientes sin síntomas depresivos en el SDMT, TMT (A, B y B-A) y PASAT-BNB (tiempo de ejecución). Conclusiones. El impacto de la enfermedad no se evidenció de forma generalizada en el rendimiento neuropsicológico de los pacientes con EM remitente recurrente. Los síntomas depresivos parecen desempeñar un papel importante en la determinación de los déficits de velocidad. Mientras que la EM redujo la velocidad de procesamiento, los síntomas depresivos en la EM se asociaron a un déficit específico en ciertos procesos cognitivos diferentes de los de velocidad (AU)
Introduction. Reduced speed of information processing seems to characterize neuropsychological performance in multiple sclerosis (MS) patients. However, the impact in speed of information processing of depressive symptoms, that are highly prevalent in this population, has not been precisely defined yet due to the presence of some methodological limitations in most preceding studies. Subjects and methods. 42 MS remittent recurrent patients, 20 with depressive symptoms (BDI > 13), and 22 without, were compared to 24 healthy controls in neuropsychological tasks of speed of processing (SDMT, Stroop, TMT y PASAT-BNB). Results. MS patients without depressive symptoms performed significantly worse than healthy controls the Stroop (W, C and WC), and the PASAT-BNB (execution time) tests. MS patients with depressive symptoms performed significantly worse than healthy controls the Stroop (W, C and WC), SDMT, TMT (A, B and B-A), and the PASAT-BNB (execution time and errors) tests. MS patients with depressive symptoms performed significantly worse than MS patients without depressive symptoms the SDMT, TMT (A, B and B-A), and the PASAT-BNB (execution time) tests. Conclusions. MS impact was not generalized in neuropsychological performance of patients. Depressive symptoms seem to play and important role determining the speed deficit. While MS reduced speed of information processing, depressive symptoms were associated to specific cognitive deficit different from speed ones (AU)
Subject(s)
Humans , Executive Function , Cognition Disorders , Multiple Sclerosis, Relapsing-Remitting/psychology , Depression/psychology , Attention , Neuropsychological Tests , Reaction TimeABSTRACT
Cannabis is one of the most widely used illicit drugs in the world. In healthy individuals cannabis is associated with cognitive impairments. Research into the effect of cannabis use in schizophrenia has yielded contradictory findings. Our aim has been to explore the correlates of cannabis use in cognitive and psychopathological features, both cross-sectional and longitudinally, in early phases of schizophrenia. 104 patients with a first episode of non-affective psychosis and 37 healthy controls were studied. Patients were classified according to their use of cannabis prior to the onset of the illness (47 users vs. 57 non-users). They were cross-sectionally and longitudinally studied and compared on clinical and cognitive variables and also on their level of premorbid adjustment. Cannabis user patients had better attention and executive functions than non-cannabis user patients at baseline and after 1 year of treatment. Both groups showed similar improvement in their cognitive functioning during the 1-year follow-up period. We also found that users had a better social premorbid adjustment, particularly during the early periods of life. The amount of cannabis consumed and the length of time of consumption did not significantly relate to cognitive performance. The use of cannabis does not seem to be associated with a negative effect on cognition in a representative sample of first-episode schizophrenia patients. Cannabis user patients appear to comprise a subgroup of patients with a better premorbid adjustment and premorbid frontal cognitive functions.
