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Cognitive performance during the first year of treatment in first-episode schizophrenia: a case–control study

Published online by Cambridge University Press:  22 May 2015

M. R. Olivier ,
S. Killian ,
B. Chiliza ,
L. Asmal ,
R. Schoeman ,
P. P. Oosthuizen ,
M. Kidd  and
R. Emsley
M. R. Olivier
Affiliation:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
S. Killian
Affiliation:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
B. Chiliza
Affiliation:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
L. Asmal
Affiliation:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
R. Schoeman
Affiliation:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
P. P. Oosthuizen
Affiliation:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
M. Kidd
Affiliation:
Centre for Statistical Consultation, Stellenbosch University, South Africa
R. Emsley*
Affiliation:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa
*
*Address for correspondence: R. Emsley, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg Campus, Cape Town 7505, South Africa. (Email: rae@sun.ac.za)
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Abstract

Background

Several questions remain unanswered regarding the magnitude and time course of cognitive improvement in response to antipsychotic treatment. The purpose of this study was to assess changes in cognitive performance in antipsychotic-naive or minimally medicated patients with first-episode schizophrenia during the first 12 months of treatment, in a case–control design. Patients were treated with flupenthixol decanoate depot injection, according to a standard algorithm. The primary outcome measure was change in MATRICS Cognitive Consensus Battery (MCCB) composite score over 12 months.

Method

The sample comprised 92 patients and 100 healthy controls matched for age, sex, ethnicity and educational status. Cognitive function was assessed by means of the MCCB.

Results

A mixed-effects model identified a significant group × time effect (p ≤ 0.0001) for the MCCB composite score, with patients showing a greater degree of change than the controls. For the other MCCB domains there were significant group × time effects at adjusted significance level for attention and vigilance (p ≤ 0.0001), visual learning (p ≤ 0.0001), verbal learning (p = 0.005) and working memory (p ≤ 0.0001), but not for reasoning and problem solving (p = 0.04), speed of processing (p = 0.03) and social cognition (p = 0.06). There were moderate correlations between change in MCCB composite score and change in symptomatology as assessed by Positive and Negative Syndrome Scale factor analysis-derived domains.

Conclusions

Substantial improvements in cognitive function were observed over and above a practice effect, and were significantly correlated with improvements in psychopathology and functionality.

Keywords

Flupenthixol decanoateneurocognitionoutcomepsychosis
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 13 , October 2015 , pp. 2873 - 2883
Copyright
Copyright © Cambridge University Press 2015 

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