Relationship between cognition and age at onset of first-episode psychosis: comparative study between adolescents, young adults, and adults

Psychotic disorders typically manifest from late adolescence to early adulthood, and an earlier onset might be associated with greater symptom severity and a worse long-term prognosis. This study aimed to compare the cognitive characteristics of patients with first-episode psychosis (FEP) by their a...

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Published in:	European child & adolescent psychiatry 2023-04, Vol.32 (4), p.639-649
Main Authors:	De la Serna, E., Puig, O., Mezquida, G., Moreno-Izco, L., Merchan-Naranjo, J., Amoretti, S., Ruiz, P., Gonzalez-Pinto, A., Molina-García, M., Corripio, I., Vieta, E., Baeza, I., Berge, D., Penadés, R., Sanchez-Torres, A., Cuesta, M. J., Bernardo, M., Castro-Fornieles, J.
Format:	Article
Language:	eng
Subjects:	Adolescent Adolescents Adult Age Age of Onset Antipsychotics Child and Adolescent Psychiatry Clinical assessment Clinical variables Cognition Cognition & reasoning Cognitive ability Comparative studies Drugs Economic status Executive function First time Humans Information processing Intelligence Language Longitudinal Studies Medical prognosis Medicine Medicine & Public Health Memory Neuropsychological assessment Neuropsychological Tests Original Contribution Premorbid Psychiatry Psychosis Psychotic Disorders - psychology Short term memory Sociodemographics Socioeconomic factors Socioeconomic status Statistical analysis Sustained attention Teenagers Verbal memory Young Adult Young adults
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Summary:	Psychotic disorders typically manifest from late adolescence to early adulthood, and an earlier onset might be associated with greater symptom severity and a worse long-term prognosis. This study aimed to compare the cognitive characteristics of patients with first-episode psychosis (FEP) by their age at onset. We included 298 patients diagnosed with FEP and classified them as having an early onset (EOS), youth onset (YOS), or adult onset (AOS) based on age limits of ≤ 18 years ( N = 61), 19–24 years ( N = 121), and ≥ 25 years ( N = 116), respectively. Socio-demographic and clinical variables included age at baseline, gender, socio-economic status, antipsychotic medication, DSM-IV diagnoses assessed by clinical semi-structured interview, psychotic symptom severity, and age at onset. Neuropsychological assessment included six cognitive domains: premorbid intelligence, working memory, processing speed, verbal memory, sustained attention, and executive functioning. The EOS group had lower scores than the YOS or AOS groups in global cognition, executive functioning, and sustained attention. Although the scores in the YOS group were intermediate to those in the EOS and AOS groups for most cognitive factors, no statistically significant differences were detected between the YOS and AOS groups. Age at onset results in specific patterns of cognitive interference. Of note, impairment appears to be greater with EOS samples than with either YOS or AOS samples. A longitudinal study with a larger sample size is needed to confirm our findings.
ISSN:	1018-8827 1435-165X