Longitudinal clinical and functional outcome in distinct cognitive subgroups of first-episode psychosis: a cluster analysis.

Autor:	Oomen PP; Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Begemann MJH; Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Brand BA; Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., de Haan L; Department of Early Psychosis, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands., Veling W; Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Koops S; Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., van Os J; Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MheNS), Maastricht University Medical Centre, Maastricht, The Netherlands.; King's College London, King's Health Partners Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK., Smit F; Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands.; Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands.; Centre of Economic Evaluation & Machine Learning, Trimbos Institute (Netherlands Institute of Mental Health), Utrecht, The Netherlands., Bakker PR; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MheNS), Maastricht University Medical Centre, Maastricht, The Netherlands.; Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands., van Beveren N; Antes Center for Mental Health Care, Rotterdam, The Netherlands.; Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands.; Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands., Boonstra N; NHL/Stenden, University of Applied Sciences, Leeuwarden, The Netherlands.; KieN VIP Mental Health Care Services, Leeuwarden, The Netherlands., Gülöksüz S; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MheNS), Maastricht University Medical Centre, Maastricht, The Netherlands.; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA., Kikkert M; Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands., Lokkerbol J; Centre of Economic Evaluation & Machine Learning, Trimbos Institute (Netherlands Institute of Mental Health), Utrecht, The Netherlands., Marcelis M; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Center, Maastricht, The Netherlands.; Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands., Rosema BS; Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., de Beer F; Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Gangadin SS; Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Geraets CNW; Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., van 't Hag E; Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Haveman Y; Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., van der Heijden I; Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.; Janssen-Cilag B.V., Breda, the Netherlands., Voppel AE; Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Willemse E; Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., van Amelsvoort T; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MheNS), Maastricht University Medical Centre, Maastricht, The Netherlands.; Mondriaan Mental Health Care, Heerlen, The Netherlands., Bak M; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MheNS), Maastricht University Medical Centre, Maastricht, The Netherlands.; Mondriaan Mental Health Care, Heerlen, The Netherlands., Batalla A; Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands., Been A; Dimence Institute for Mental Health, Deventer, Zwolle, The Netherlands., van den Bosch M; Dimence Institute for Mental Health, Deventer, Zwolle, The Netherlands., van den Brink T; Early Intervention Team, GGZ Centraal, Amersfoort, The Netherlands., Faber G; Yulius, Mental Health Institute, Dordrecht, The Netherlands., Grootens KP; Reinier van Arkel Institute for Mental Health Care, 's Hertogenbosch, The Netherlands., de Jonge M; Program for Psychosis & Severe Mental Illness, Pro Persona Mental Health, Wolfheze, The Netherlands., Knegtering R; Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.; Lentis Research, Lentis Psychiatric Institute, Groningen, The Netherlands., Kurkamp J; Center for Youth with Psychosis, Mediant ABC Twente, Enschede, The Netherlands., Mahabir A; Early Psychosis Team, GGNet, Apeldoorn, The Netherlands., Pijnenborg GHM; Department of Psychotic Disorders, GGZ-Drenthe, Assen, The Netherlands.; Department of Clinical and Developmental Neuropsychology, Faculty BSS, University of Groningen, Groningen, The Netherlands., Staring T; Department ABC Early Psychosis, Altrecht Psychiatric Institute, Utrecht, The Netherlands., Veen N; GGZ Delfland, Delfland Institute for Mental Health Care, Delft, The Netherlands., Veerman S; Community Mental Health, Mental Health Service Noord-Holland Noord, Alkmaar, The Netherlands., Wiersma S; Early Intervention Psychosis Team, GGZ inGeest Specialized Mental Health Care, Hoofddorp, The Netherlands., Graveland E; Yulius, Mental Health Institute, Dordrecht, The Netherlands., Hoornaar J; Antes Center for Mental Health Care, Rotterdam, The Netherlands., Sommer IEC; Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jazyk:	angličtina
Zdroj:	Psychological medicine [Psychol Med] 2023 Apr; Vol. 53 (6), pp. 2317-2327. Date of Electronic Publication: 2021 Oct 19.
DOI:	10.1017/S0033291721004153
Abstrakt:	Background: Cognitive deficits may be characteristic for only a subgroup of first-episode psychosis (FEP) and the link with clinical and functional outcomes is less profound than previously thought. This study aimed to identify cognitive subgroups in a large sample of FEP using a clustering approach with healthy controls as a reference group, subsequently linking cognitive subgroups to clinical and functional outcomes. Methods: 204 FEP patients were included. Hierarchical cluster analysis was performed using baseline brief assessment of cognition in schizophrenia (BACS). Cognitive subgroups were compared to 40 controls and linked to longitudinal clinical and functional outcomes (PANSS, GAF, self-reported WHODAS 2.0) up to 12-month follow-up. Results: Three distinct cognitive clusters emerged: relative to controls, we found one cluster with preserved cognition ( n = 76), one moderately impaired cluster ( n = 74) and one severely impaired cluster ( n = 54). Patients with severely impaired cognition had more severe clinical symptoms at baseline, 6- and 12-month follow-up as compared to patients with preserved cognition. General functioning (GAF) in the severely impaired cluster was significantly lower than in those with preserved cognition at baseline and showed trend-level effects at 6- and 12-month follow-up. No significant differences in self-reported functional outcome (WHODAS 2.0) were present. Conclusions: Current results demonstrate the existence of three distinct cognitive subgroups, corresponding with clinical outcome at baseline, 6- and 12-month follow-up. Importantly, the cognitively preserved subgroup was larger than the severely impaired group. Early identification of discrete cognitive profiles can offer valuable information about the clinical outcome but may not be relevant in predicting self-reported functional outcomes.
Databáze:	MEDLINE
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