Cognitive profiles of three clusters of patients with a first-episode psychosis

Schizophr Res. 2013 Oct;150(1):151-6. doi: 10.1016/j.schres.2013.07.054. Epub 2013 Aug 16.

Abstract

Objective: The primary objective was to identify specific groups of patients with a first-episode psychosis based on family history, obstetric complications, neurological soft signs, and premorbid functioning. The secondary objective was to relate these groups with cognitive variables.

Method: A total of 62 first-episode psychoses were recruited from adult and child and adolescent mental health services. The inclusion criteria were patients between 7 and 65 years old (real range of the samples was 13-35 years old), two or more psychotic symptoms and less than one year from the onset of the symptoms. Premorbid functioning (PAS), soft signs (NES), obstetric complications and a neuropsychological battery (CPT, TMTA/TMTB, TAVEC/TAVECI, Stroop, specific subtest of WAIS-III/WISC-IV) were administered.

Results: We found three clusters: 1) higher neurodevelopment contribution (N=14), 2) higher genetic contribution (N=30), and 3) lower neurodevelopment contribution (N=18). Statistical differences were found between groups in TMTB, learning curve of the TAVEC, digits of the WAIS and premorbid estimated IQ, the cluster 1 being the most impaired.

Conclusions: A cluster approach could differentiate several groups of patients with different cognitive performance. Neuropsychological interventions, as cognitive remediation, should be addressed specifically to patients with more impaired results.

Keywords: Cluster analysis; Family history; First-episode psychosis; Neurodevelopment; Neuropsychology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Cluster Analysis
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology*
  • Female
  • Humans
  • Male
  • Neuropsychological Tests
  • Psychotic Disorders / complications*
  • Psychotic Disorders / psychology
  • Young Adult