The impact of early intervention for first episode psychosis on cognitive functioning.

Autor: Mueser KT; Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA; Department of Occupational Therapy, Boston University, Boston, MA, USA. Electronic address: mueser@bu.edu., Sussman RF; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA., DeTore NR; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA., Eberlin ES; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA., McGurk SR; Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA; Department of Occupational Therapy, Boston University, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Schizophrenia research [Schizophr Res] 2023 Oct; Vol. 260, pp. 132-139. Date of Electronic Publication: 2023 Aug 30.
DOI: 10.1016/j.schres.2023.07.021
Abstrakt: Importance: Impaired cognitive functioning is a core characteristic of schizophrenia, present from the onset of the illness and relatively stable thereafter. Despite evidence supporting the impact of early intervention services (EIS) on improving symptoms and functioning in first episode psychosis (FEP), controlled research has not examined its impact on cognitive functioning.
Objective: To evaluate the longitudinal course of cognitive functioning in FEP patients participating in a large, controlled study comparing EIS with usual services.
Methods: A total of 404 persons ages 15-40 years old with non-affective FEP participated in the Recovery After Initial Schizophrenia-Early Treatment Program. A cluster randomized controlled trial was conducted with 34 community mental health treatment centers across the U.S. randomized to provide either an EIS program (NAVIGATE) or usual Community Care (CC) to FEP patients for 2 years. Cognitive functioning was assessed with the Brief Assessment of Cognition in Schizophrenia (BACS) at baseline and 1- and 2-years later.
Results: Older participants (≥20 years old) in both treatment groups improved on all BACS tests. Younger participants (15-19) in NAVIGATE improved significantly more on Digit Sequencing (working memory) than those in CC, whereas both groups improved on most of the other BACS tests. Improvements in cognitive functioning occurred mostly over the first year and were correlated with reductions in symptom severity.
Discussion: EIS do not improve cognitive functioning more than usual care for older FEP patients but may improve working memory in younger FEP patients. Interventions targeting cognition may be required to enhance cognitive functioning in most FEP patients.
Competing Interests: Declaration of competing interest All authors have no financial disclosures to report.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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