Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia
Zaragoza Domingo, Silvia (Universitat Autònoma de Barcelona. Departament de Psiquiatria i de Medicina Legal)
Bobes, Julio (Centro de Investigación Biomédica en Red de Salud Mental)
García-Portilla, Maria-Paz (Universidad de Oviedo)
Morralla, Claudia (Sanofi-Aventis)

Date:	2015
Abstract:	Prevalence data of cognitive impairment in Schizophrenia based on large population samples are scarce. Our goal is to relate cognition and functional outcomes, and estimate prevalence of cognitive impairment in a large sample of schizophrenia outpatients treated with second-generation antipsychotics. A cross-sectional outpatient evaluation conducted during follow-up visits. Selection criteria included six-months stable treatment. The brief battery, EPICOG-SCH, covered four cognitive domains related to functional outcomes: working memory (WAIS-III-Letter-Number-Sequencing), executive function (Category Fluency Test; CFT), verbal memory (WMS-III-Logical-Memory), and information processing speed (Digit-Symbol-Coding and CFT). Clinical severity and functional impairment were assessed with CGI-SCH and WHO DAS-S. Impairment prevalence was calculated at ≤ 1. 5 SD. Among patients recruited (n = 848) in 234 participating centers, 672 were under 6-month treatment. 61. 5% (n = 413) reported cognitive impairment according to CGI-SCH Cognitive Subscale. Estimated prevalences were 85. 9% (95% CI 85. 6-86. 2%) CFT-Fruits; 68. 3% (95% CI 67. 8-68. 8%) CFT- Animals ; 38. 1% (95% CI 37. 5-38. 3%) Digit-Symbol-Coding; 24. 8% (95% CI 24. 1-25. 5%) Verbal Memory-Units ; 20. 9% (95% CI 20. 2-21. 6%) Letter-Number Sequencing; 11. 7% (95% CI 11. 0-12. 4%) Verbal Memory-Items. Negative and Depressive symptoms, Deficit Syndrome, and functional disability were related to poor performance. Functional disability was predicted by CGI-SCH-Overall severity (OR = 1. 34635, p < 0. 0001), CGI-SCH-Negative Symptoms (OR = 0. 75540, p < 0. 0001), working memory (Letter-Number-Sequencing) (OR = − 0. 16442, p = 0. 0004) and the time-course (OR = 0. 05083, p = 0. 0094), explaining 47% of the observed variability. Most prevalent impairments were on executive function and processing speed domains; however, working memory showed the strongest relationship to functional disability. Monitoring cognitive function during follow up is critical to understand patient's everyday functional capacity.
Note:	Altres ajuts: Funding for this study was provided by Sanofi-Aventis. Portions of this study's results were presented at the Joint MidYear Meeting of the International Neuropsychological Society, the Federation of Spanish Societies of Neuropsychology, the Spanish Neuropsychological Society and the Spanish Psychiatry Society held in Bilbao in July 2007. Partial results were also presented in poster form at the 20th European Clinical Neuropsychological Society (ECNP) Congress, (October 13-17, 2007) and at the 14th Biennial Winter Workshop on Schizophrenia
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Cognition ; Functional outcome ; Neuropsychology ; Outpatient ; Schizophrenia ; Epidemiology
Published in:	Schizophrenia Research: Cognition, Vol. 2 (april 2015) , p. 146-158, ISSN 2215-0013

DOI: 10.1016/j.scog.2015.03.002
PMID: 29379764

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