1. Duration of Untreated Illness/Psychosis and Cognitive Functioning
Charlotte Rapp, MSc; Erich Studerus, PhD; Hilal Bugra, MSc; Jacqueline Aston, MD; Corinne Tamagni, PhD; Anna Walter, MD; Stefan Borgwardt, MD; Anita Riecher-Rössler, MD
University of Basel Psychiatric Clinics, Switzerland
Background
Studies examining the influence of duration of untreated psychosis (DUP)/duration of untreated illness (DUI) on cognition vary with regards to results and methods. The aim of this study was to investigate the relationship between DUP/DUI and cognitive functioning in neuroleptic-naïve subjects with a first episode psychosis (FEP) or an at risk mental state with later transition to psychosis (ARMS-T).
Method
42 FEP and 12 ARMS-T patients were examined in the FePsy study for early detection of psychosis (1,2). Associations between DUP/DUI and neurocognitive performance were tested by three different operationalizations of cognition: as the raw outcome measure of different neuropsychological tests, as outcome scores which were normed on a sample of 75 healthy subjects, and as the deterioration index (DI), which assesses the discrepancy between “hold” and “non-hold“ cognitive function.
Results
Figure 1 shows the DUP and DUI distributions in the different subgroups. There was a significant negative correlation between DUP and outcome of the Wisconsin Card Sorting Test in both normed (p<0.05) and raw scores (p<0.05) (Table 2). When adjusted for covariates, DUP and DUI did not significantly predict any cognitive performance (Figure 2). There was also no significant relationship between DUP/DUI and the DI index. However, the DI index was significantly predicted by cannabis use (p<0.05).
* p < 0.05; ** p < 0.01; *** p < 0.001
Figure 2: Predictors of cognition: cognitive test scores as dependent variables and log DUP/log DUI, age, gender, education, cannabis consumption, SANS negative and BPRS positive symptoms as independent variables
Summary and Conclusions
This study could not confirm a strong overall association between duration of untreated psychosis and neurocognitive performance. This could be because schizophrenic psychoses are neurodevelopmental disorders in which most cognitive deficits exist long before the onset of psychiatric symptoms.
Contact
M. Sc. Charlotte Rapp /
References
1. Riecher-Rössler, A., et al., Efficacy of Using Cognitive Status in Predicting Psychosis: A 7-Year Follow-Up. Biological Psychiatry, (11): p
2. Riecher-Rössler, A., et al., The Basel early-detection-of-psychosis (FEPSY)-study - design and preliminary results. Acta Psychiatrica Scandinavica, (2): p
Disclosure Information
Charlotte Rapp was supported by a grant by the EU for EU-GEI. Hilal Bugra was supported by a grant by the Stanley Foundation for the Neurapro-E study. Corinne Tamagni, Anna Walter, Stefan Borgwardt and Anita Riecher-Rössler were supported by a grant by the Swiss National Science Foundation (SNF), Grant No _127323/1.
Figure 1: Duration of untreated illness (DUI) / duration of untreated psychosis (DUP)