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Neuropsychological Trajectories Predict Functional Changes in Young Adults with Early-Stage Schizophrenia, Major Depressive and Bipolar Disorders
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Neuropsychological Trajectories Predict Functional Changes in Young Adults with Early-Stage Schizophrenia, Major Depressive and Bipolar Disorders

R S Lee, Daniel F Hermens, Sharon L Naismith, Jim Lagopoulos, Elizabeth M Scott and Ian B Hickie
Biological Psychiatry, Vol.75(9, Supplement), p.331S
Annual Scientific Convention and Meeting of the Society of Biological Psychiatry, 69th (New York, United States, 2014)
2014
DOI: https://doi.org/10.1016/j.biopsych.2014.03.016
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https://doi.org/10.1016/j.biopsych.2014.03.016View
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Abstract

Biological Sciences Medical and Health Sciences Psychology and Cognitive Sciences neuropsychology longitudinal depression bipolar disorder schizophrenia
Background: Few studies have examined the neuropsychological trajectory of early-stage mood disorders, and whether this differs from schizophrenia-spectrum illnesses remains unclear. We prospectively tracked cognitive functions in earlyepisode major depressive (MDD) and bipolar disorders (BD), and compared this to recent-onset schizophrenia (SCZ) and healthy controls (HC), to clarify potential cross-diagnostic phenotypes or cognitive trajectories useful in predicting real-world functional changes. Methods: One-hundred-and-five participants (M=21.6 years old, SD=4.3; MDD=34, BD=29, SCZ=30, HC=12) were assessed at baseline, and re-assessed, on average, 22.2 months later. There were no overall group differences in age, illness duration, or follow-up interval (p>0.05). Results: At baseline, clinical subjects were worse on memory and executive measures than HC (p<0.05). There was no significant further decline in any neuropsychological measure at follow-up. Verbal [F(1 86)=8.02, p<0.01] and visuospatial memory [F(1 83)=4.12, p<0.05] improved at follow-up, although group-by-time interactions were not significant (p>0.05). Functional gains were significantly predicted by improved verbal memory (Social Functioning Scale: β=0.37, p<0.01), visuospatial memory (WHODAS-II: β=-0.27, p<0.05), and spatial working memory (SOFAS: β=0.24, p<0.05); these remained significant while controlling for depressive, manic, positive, and negative symptom changes. Symptom changes were not predictive of neuropsychological or functional changes (p>0.05). Conclusions: Early-stage mood and psychotic disorders shared mnemonic and prefrontal-executive deficits, highlighting disruptions to fronto-temporal brain functions spanning traditional diagnostic boundaries. Short-term neuropsychological decline was not evident in stabilised patients with these disorders. Diagnoses did not differentiate neuropsychological trajectories, and symptom alleviation did not predict functional gains. Conversely, neuropsychological improvement was a robust predictor of reductions in realworld disability.

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