Cognitive Impairment Associated with First-Episode Schizophrenia

Stefanie Cavalcanti, MD

Patients with schizophrenia often have adverse effects, such as depressive symptoms and cognitive dysfunction.

While cognitive impairment has been linked to patients with a depressive disorder, there is a lack of research about the relationship between depressive symptoms and cognitive impairment in patients with never-treated first episode (NTFE) schizophrenia.

Investigators, led by Stefanie Cavalcanti, MD of the McGovern Medical School at the University of Texas Health Science Center, found the rate of depressive symptoms in NTFE schizophrenia patients is high, which is correlated with cognitive impairment.

The results were presented at the American Psychiatric Association Annual Meeting this weekend.

Study

The team examined how symptoms correlated with cognitive impairment in patients with NTFE schizophrenia.

Data was collected through the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The assessment was performed in 78 NTFE patients and 80 controls, matched through sex, age, and education level, to evaluate cognitive function in the patients.

Investigators then used the 17-item Hamilton Depression Rating Scale (HAMD-17) to evaluate depressive symptoms and the Positive and Negative Syndrome Scale (PANSS) to evaluate psychopathological symptoms.

Results

A total of 39 patients (49.4%) met criteria for comorbid depressive symptoms. The patients had a total score of ≥ 8 in the HAMD-17. A total of 40 patients was used for non-depression control.

Investigators found the RBANS total and 4 index scores of patients with NTFE were significantly lower than the patients in the healthy control group.

The team also found patients with depressive symptoms had lower scores that patients without depressive symptoms in the attention index, PANSS general psychopathology and PANSS total scores (all P < .05)

The attention index for patients with depression was 81.8 versus 90.2 for patients in the non-depression group, (F (4.52), df (1, 77), P = .037).

PANSS general psychopathology score was 44.7 in patients with depression and 35.4 in patients without depression (F/x2­ 14.24, df (1,77), P = .0). The PANNS total score was 89.9 in patients with depression and 79.5 in patients without depression (F/x2­ 6.26, df (1,77), P = .015).

A correction analysis conducted by investigators found the HAMD total score had a significant correlation with attention, PANSS total, and the PANSS generally psychopathology scores (all P <.05).

Using multiple regression, the team also identified education (0.31, t = 2.79, P = .01) and HAMD-17 score (-.0.33, t = -2.53, P = 0.01) as contributors to attention on the RBANS.

Conclusion

Investigators concluded the data show the rate of depressive symptoms in patients with NTFE schizophrenia is high, which can be correlated to cognitive impairment.

“Our results suggest that the rate of depressive symptoms in first-episode drug naïve (FEND) schizophrenia is high, which is correlated with its cognitive impairment, especially attention and psychopathology,” investigators wrote.

The study, “Association of Depressive Symptoms With Cognitive Impairment in Patients With Never-Treated First-Episode Schizophrenia,” was presented online by the American Psychiatric Association.