Cognitive predictors of clinical outcome in early course of psychosis

Abstract

This study aims to explore potential predictors of clinical outcomes in terms of cognitive markers in a psychosis. A total of 153 patients presenting first-episode psychosis were recruited, out of which 90 were available for analysis up to 20-month follow-up. They were tested with neurocognitive tests including Logical Memory Test, Visual Reproduction (VR). Verbal Fluency Test (VF), and Wisconsin Card Sorting Test (WCST) upon admission, discharge, and every 4 months up to 20-month follow-up. Clinical outcome was measured by the Positive and Negative Syndrome Scale (PANSS). Linear regression analysis, with independent variables of the test scores at admission and discharge (for the first-episode psychosis), as well as improvement between the two time points, was employed in identifying potential predictors of clinical outcomes. Dependent variables were positive symptom, negative symptom, and total symptom scores of PANSS at 20-month follow-up. Improvement in WCST category score was the only predictor of positive symptoms which accounted for 6% of variance [F(1,81 = 5.737, p = 0.019), while performance on VF at admission and VR (immediate recall) at discharge altogether accounted for 12% of variance of negative symptoms [F(2,80) = 6.334, p = 0.003]. For total PANSS score, improvement in WCST category score and performance on VR Ždelayed recall. Upon discharge accounted for 11% of variance [F(2,80) = 6.133, p = 0.003]. In conclusion, performance on WCST category score and VR appear to be crucial determinants of clinical outcome in early course of illness.