Prognostic value of cognitive functioning for global functional recovery in first-episode schizophrenia

It has become widely accepted that cognitive deficits in schizophrenia are related to functional outcome. However, it remains to be seen whether these associations are relevant for predicting which cases will have a global functional recovery. In this study, we attempt to determine whether global fu...

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Bibliographic Details
Published in:Psychological medicine 2010-06, Vol.40 (6), p.935-944
Main Authors: González-Blanch, C., Perez-Iglesias, R., Pardo-García, G., Rodríguez-Sánchez, J. M., Martínez-García, O., Vázquez-Barquero, J. L., Crespo-Facorro, B.
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Antipsychotic Agents - therapeutic use
Attention - drug effects
Biological and medical sciences
Classification
Clinical outcomes
Cognition & reasoning
Cognition Disorders - diagnosis
Cognition Disorders - psychology
Cognition Disorders - rehabilitation
Cognitive deficits
Cohort Studies
Disability Evaluation
Female
first episode
First time
Functional impairment
Humans
Independent Living - psychology
Long term effects
Longitudinal Studies
Male
Medical prognosis
Medical sciences
Neuropsychological Tests
predictors
Prognosis
Psychiatric Status Rating Scales
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychoses
Psychotic Disorders - diagnosis
Psychotic Disorders - psychology
Psychotic Disorders - rehabilitation
Randomized Controlled Trials as Topic
Recovery
Rehabilitation, Vocational
Schizophrenia
Schizophrenia - diagnosis
Schizophrenia - rehabilitation
Schizophrenic Psychology
Social Adjustment
Spain
Young Adult
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Summary:It has become widely accepted that cognitive deficits in schizophrenia are related to functional outcome. However, it remains to be seen whether these associations are relevant for predicting which cases will have a global functional recovery. In this study, we attempt to determine whether global functional recovery (integrating social and occupational outcomes) after first-episode schizophrenia (FES) can be predicted by cognitive variables. A total of 131 FES patients with functional deficits (n=97) and functional recovery (n=34) as determined at 1-year follow-up were examined. Neuropsychological, sociodemographic, pre-morbid and clinical data at baseline were analysed using independent groups comparisons and a logistic regression method. Sustained attention and negative symptoms emerged as significant predictors of good global functional outcome. Although the model revealed a high accuracy (91%) in the classification of patients with functional deficits, it was unacceptably low (26%) in the classification of patients with global functional recovery. The limitations found in the prediction of a favourable global functional outcome may well be an indication for a need to address the role of other factors not commonly included in longitudinal studies of long-term outcomes in schizophrenia.
ISSN:0033-2917
1469-8978
DOI:10.1017/S0033291709991267