. 2023 May:255:173-181.

doi: 10.1016/j.schres.2023.03.020. Epub 2023 Mar 29.

Cognitive performance at first episode of psychosis and the relationship with future treatment resistance: Evidence from an international prospective cohort study

Edward Millgate¹, Sophie E Smart², Antonio F Pardiñas², Eugenia Kravariti¹, Olesya Ajnakina³, Adrianna P Kępińska¹, Ole A Andreassen⁴, Thomas R E Barnes⁵, Domenico Berardi⁶, Benedicto Crespo-Facorro⁷, Giuseppe D'Andrea⁶, Arsime Demjaha¹, Marta Di Forti⁸, Gillian A Doody⁹, Laura Kassoumeri¹, Aziz Ferchiou¹⁰, Lorenzo Guidi¹¹, Eileen M Joyce¹², Ornella Lastrina¹¹, Ingrid Melle⁴, Baptiste Pignon¹⁰, Jean-Romain Richard¹³, Carmen Simonsen¹⁴, Andrei Szöke¹⁰, Ilaria Tarricone¹¹, Andrea Tortelli¹⁵, Javier Vázquez-Bourgon¹⁶, Robin M Murray¹, James T R Walters², James H MacCabe¹⁷; STRATA Consortium

Affiliations

¹ Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
² MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
³ Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK.
⁴ Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
⁵ Division of Psychiatry, Imperial College London, UK.
⁶ Department of Biomedical and Neuro-motor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy.
⁷ Department of Psychiatry, Hospital Universitario Virgen del Rocio, IBiS, Universidad de Sevilla, Spain; Centro de Investigacion en Red Salud Mental (CIBERSAM), Sevilla, Spain.
⁸ Social Genetics and Developmental Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; South London and Maudsley NHS Mental Health Foundation Trust, London, UK.
⁹ Department of Medical Education, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, UK.
¹⁰ Univ Paris Est Creteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, Creteil, France; AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, FHU ADAPT, Creteil, France.
¹¹ Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), Alma Mater Studiorum - University of Bologna, Bologna, Italy.
¹² Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, UK.
¹³ Univ Paris Est Creteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, Creteil, France.
¹⁴ Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway (TIPS Sør-Øst), Division of Mental Health and Addiction, Oslo University Hospital, Norway.
¹⁵ Univ Paris Est Creteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, Creteil, France; Groupe Hospitalier Universitaire Psychiatrie Neurosciences Paris, Pôle Psychiatrie Précarité, Paris, France.
¹⁶ Centro de Investigacion en Red Salud Mental (CIBERSAM), Sevilla, Spain; Department of Psychiatry, University Hospital Marques de Valdecilla - Instituto de Investigación Marques de Valdecilla (IDIVAL), Santander, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain.
¹⁷ Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; South London and Maudsley NHS Mental Health Foundation Trust, London, UK. Electronic address: james.maccabe@kcl.ac.uk.

PMID: 37001392
PMCID: PMC10390338
DOI: 10.1016/j.schres.2023.03.020

Cognitive performance at first episode of psychosis and the relationship with future treatment resistance: Evidence from an international prospective cohort study

Edward Millgate et al. Schizophr Res. 2023 May.

. 2023 May:255:173-181.

doi: 10.1016/j.schres.2023.03.020. Epub 2023 Mar 29.

Authors

Affiliations

¹ Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
² MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
³ Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK.
⁴ Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
⁵ Division of Psychiatry, Imperial College London, UK.
⁶ Department of Biomedical and Neuro-motor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy.
⁷ Department of Psychiatry, Hospital Universitario Virgen del Rocio, IBiS, Universidad de Sevilla, Spain; Centro de Investigacion en Red Salud Mental (CIBERSAM), Sevilla, Spain.
⁸ Social Genetics and Developmental Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; South London and Maudsley NHS Mental Health Foundation Trust, London, UK.
⁹ Department of Medical Education, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, UK.
¹⁰ Univ Paris Est Creteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, Creteil, France; AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, FHU ADAPT, Creteil, France.
¹¹ Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), Alma Mater Studiorum - University of Bologna, Bologna, Italy.
¹² Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, UK.
¹³ Univ Paris Est Creteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, Creteil, France.
¹⁴ Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway (TIPS Sør-Øst), Division of Mental Health and Addiction, Oslo University Hospital, Norway.
¹⁵ Univ Paris Est Creteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, Creteil, France; Groupe Hospitalier Universitaire Psychiatrie Neurosciences Paris, Pôle Psychiatrie Précarité, Paris, France.
¹⁶ Centro de Investigacion en Red Salud Mental (CIBERSAM), Sevilla, Spain; Department of Psychiatry, University Hospital Marques de Valdecilla - Instituto de Investigación Marques de Valdecilla (IDIVAL), Santander, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain.
¹⁷ Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; South London and Maudsley NHS Mental Health Foundation Trust, London, UK. Electronic address: james.maccabe@kcl.ac.uk.

PMID: 37001392
PMCID: PMC10390338
DOI: 10.1016/j.schres.2023.03.020

Erratum in

Corrigendum to "Cognitive performance at first episode of psychosis and the relationship with future treatment resistance: Evidence from an international prospective cohort study" [Schizophr. Res. volume 225 (May 2023) 173-181].
Millgate E, Smart SE, Pardiñas AF, Kravariti E, Ajnakina O, Kępińska AP, Andreassen OA, Barnes TRE, Berardi D, Crespo-Facorro B, D'Andrea G, Demjaha A, Di Forti M, Doody GA, Üçok A, Kassoumeri L, Ferchiou A, Guidi L, Joyce EM, Lastrina O, Melle I, Pignon B, Richard JR, Simonsen C, Szöke A, Tarricone I, Tortelli A, Vázquez-Bourgon J, Murray RM, Walters JTR, MacCabe JH; STRATA Consortium. Millgate E, et al. Schizophr Res. 2024 Aug;270:495-496. doi: 10.1016/j.schres.2024.06.029. Epub 2024 Jul 29. Schizophr Res. 2024. PMID: 39079354 Free PMC article. No abstract available.

Abstract

Background: Antipsychotic treatment resistance affects up to a third of individuals with schizophrenia, with recent research finding systematic biological differences between antipsychotic resistant and responsive patients. Our aim was to determine whether cognitive impairment at first episode significantly differs between future antipsychotic responders and resistant cases.

Methods: Analysis of data from seven international cohorts of first-episode psychosis (FEP) with cognitive data at baseline (N = 683) and follow-up data on antipsychotic treatment response: 605 treatment responsive and 78 treatment resistant cases. Cognitive measures were grouped into seven cognitive domains based on the pre-existing literature. We ran multiple imputation for missing data and used logistic regression to test for associations between cognitive performance at FEP and treatment resistant status at follow-up.

Results: On average patients who were future classified as treatment resistant reported poorer performance across most cognitive domains at baseline. Univariate logistic regressions showed that antipsychotic treatment resistance cases had significantly poorer IQ/general cognitive functioning at FEP (OR = 0.70, p = .003). These findings remained significant after adjusting for additional variables in multivariable analyses (OR = 0.76, p = .049).

Conclusions: Although replication in larger studies is required, it appears that deficits in IQ/general cognitive functioning at first episode are associated with future treatment resistance. Cognitive variables may be able to provide further insight into neurodevelopmental factors associated with treatment resistance or act as early predictors of treatment resistance, which could allow prompt identification of refractory illness and timely interventions.

Keywords: Cognition; First episode psychosis; Prospective cohort; Psychosis; Schizophrenia; Treatment resistance.

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Conflict of interest statement

Declaration of competing interest J.T.R.W. is an investigator on a grant from Takeda Pharmaceuticals Ltd. to Cardiff University, for a project unrelated to the work presented here. S.E.S. is employed on this grant. M.D.F. has received a fee for educational seminars from Lundbeck and Janssen. O.A.A. is a consultant to HealthLytix and has received speakers honorarium from Lundbeck and Sunovion. T.R.E.B. has been a member of an advisory board for Gedeon Richter. B.C.F. has received honoraria for participation as a consultant and/or as a speaker at educational events from ADAMED, Mylan, Angelini, Janssen Johnson & Johnson, Lundbeck, and Otsuka Pharmaceuticals. R.M.M. has received payments for non-promotional lectures from Janssen, Otsuka, Sunovian, and Lundbeck. J.H.M. has received research funding from H Lundbeck.

References

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Cognitive performance at first episode of psychosis and the relationship with future treatment resistance: Evidence from an international prospective cohort study

Affiliations

Cognitive performance at first episode of psychosis and the relationship with future treatment resistance: Evidence from an international prospective cohort study

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous