Simonsen, Erik1; Barder, Helene E.2; Sundet, Kjetil2; Rund, Bjørn R.3; Evensen, Julie2; Haahr, Ulrik4; Hegelstad, Wenche Ten Velden5; Joa, Inge6; Johannessen, Jan O.6; Langeveld, Johannes6; Larsen, Tor K.7; Melle, Ingrid8; Opjordsmoen, Stein8; Rossberg, Jan I.8; Vaglum, Per8; McGlashan, Thomas9; Friis, Svein2
1 The Department of Psychology and Educational Studies, Roskilde University2 Oslo universitetssykehus3 Vestre Viken Hospital Trust4 Psykiatrien Region Sjælland5 Stavanger Universitetssjukehus6 University of Stavanger7 Universitetet i Bergen8 Universitetet i Oslo9 Yale University
Objective: Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP) and the relationship to clinically significant subgroups even more so. We report 10 year longitudinal neurocognitive development in a sample of FEP patients, and explore whether the trajectories of cognitive course are related to presence of relapse to psychosis, especially within the first year, with a focus on the course of verbal memory. Method: Forty-three FEP subjects (51% male, 28 +/- 9 years) were followed-up neurocognitively over five assessments spanning 10 years. The test battery was divided into four neurocognitive indices; Executive Function, Verbal Learning, Motor Speed, and Verbal Fluency. The sample was grouped into those relapsing or not within the first, second and fifth year. Results: The four neurocognitive indices showed overall stability over the 10 year period. Significant relapse by index interactions were found for all indices except Executive Function. Follow-up analyses identified a larger significant decrease over time for the encoding measure within Verbal Memory for patients with psychotic relapse in the first year[F-(4,F- (38)) = 5.8, p = 0.001, eta(2) = 0.40]. Conclusions: Main findings are long-term stability in neurocognitive functioning in FEP patients, with the exception of verbal memory in patients with psychotic relapse or non-remission early in the course of illness. We conclude that worsening of specific parts of cognitive function may be expected for patients with on-going psychosis, but that the majority of patients do not show significant change in cognitive performance during the first 10 years after being diagnosed.