A prospective 3-year longitudinal study of cognitive predictors of relapse in first-episode schizophrenic patients
Abstract
Background Cognitive predictors of relapse have been extensively explored only in few long term longitudinal studies of first-episode schizophrenia.Method This study prospectively followed 93 patients with first-episode schizophrenia, schizophreniform disorder, and schizoaffective disorder for 3 years after their first-episode illness. Cognitive domains including verbal intelligence, verbal and visual memory, verbal fluency, and Wisconsin Card Sorting Test performance were investigated as potential predictors of relapse.Results We found that by the first year 21% patients had relapsed, by the second year 33% had relapsed, and by the third year 40% had relapsed. There was a significant difference in the relapse rate between patients with good adherence and patients with poor adherence to medication regimes. A multiple logistic regression analysis revealed that after controlling for medication adherence, perseverative error in the Wisconsin Card Sorting Test was the only cognitive function that significantly predict relapse with an odds ratio of 2.4.Conclusions Cognitive flexibility in set shifting is related to tendency towards relapse in first-episode schizophrenic patients. Other cognitive factors appear not to be related to relapse. Possible mechanisms included the link between prefrontal dysfunction and sub-cortical dopamine system stability, as well as the effects of executive dysfunction on insight impairment and adherence behavior.
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The severity of cognitive impairment predicts increased relapse risk in first-episode patients.
“and increased relapse risk in first-episode patients.8”
From Clinical trials of potential cognitive-enhancing drugs in schizophrenia: what have we learned so far? (2013) · cites this paper as [8]
Cites
The Positive and Negative Syndrome Scale (PANSS) for schizophrenia.
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987) · Schizophrenia Bulletin · doi:10.1093/schbul/13.2.261 · Cited by 21,378 · see citing works
DSM-IV: Diagnostic and Statistical Manual of Mental Disorders
Bell, C. C. (1994) · JAMA · doi:10.1001/jama.1994.03520100096046 · Cited by 2,608 · see citing works
A Modified Card Sorting Test Sensitive to Frontal Lobe Defects
Nelson, H. E. (1976) · Cortex · doi:10.1016/s0010-9452(76)80035-4 · Cited by 2,454 · see citing works
Robinson, D., Woerner, M. G., Alvir, J. M. J., Bilder, R., Goldman, R., Geisler, S., Koreen, A., Sheitman, B., Chakos, M., Mayerhoff, D., et al. (1999) · Archives of General Psychiatry · doi:10.1001/archpsyc.56.3.241 · Cited by 1,327 · see citing works
Gating of information flow within the limbic system and the pathophysiology of schizophrenia.
Grace, A. (2000) · Brain research. Brain research reviews · doi:10.1016/s0165-0173(99)00049-1 · Cited by 532 · see citing works
Neuroleptic Withdrawal in Schizophrenic Patients
Gilbert, P. L. (1995) · Archives of General Psychiatry · doi:10.1001/archpsyc.1995.03950150005001 · Cited by 434 · see citing works
Do we still believe in the dopamine hypothesis? New data bring new evidence.
Abi-Dargham, A. (2004) · International Journal of Neuropsychopharmacology · doi:10.1017/s1461145704004110 · Cited by 373 · see citing works
Robinson, D. G., Woerner, M. G., Alvir, J. M. J., Bilder, R. M., Hinrichsen, G. A., & Lieberman, J. A. (2002) · Schizophrenia Research · doi:10.1016/s0920-9964(01)00312-7 · Cited by 290 · see citing works
Deutch, A. Y. (1992) · Springer eBooks · doi:10.1007/978-3-7091-9211-5_5 · Cited by 221 · see citing works
Neuroleptic Withdrawal in Schizophrenic Patients
Baldessarini, R. J. (1995) · Archives of General Psychiatry · doi:10.1001/archpsyc.1995.03950150021002 · Cited by 194 · see citing works
The Natural Course of Schizophrenia: A Review of First-admission Studies
Ram, R., Bromet, E. J., Eaton, W. W., Pato, C. N., & Schwartz, J. E. (1992) · Schizophrenia Bulletin · doi:10.1093/schbul/18.2.185 · Cited by 189 · see citing works
The neuropsychological basis of insight in first-episode schizophrenia: a pilot metacognitive study
Koren, D. (2004) · Schizophrenia Research · doi:10.1016/j.schres.2004.02.004 · Cited by 187 · see citing works
Insight: its relationship with cognitive function, brain volume and symptoms in schizophrenia
Rossell, S. L., Coakes, J., Shapleske, J., Woodruff, P. W. R., & David, A. S. (2002) · Psychological Medicine · doi:10.1017/s0033291702006803 · Cited by 145 · see citing works
Brake, W. G., Flores, G., Francis, D. D., Meaney, M. J., Srivastava, L. K., & Gratton, A. P. (2000) · Neuroscience · doi:10.1016/s0306-4522(00)00002-6 · Cited by 138 · see citing works
Prediction of Relapse in Schizophrenia
Lieberman, J. A. (1987) · Archives of General Psychiatry · doi:10.1001/archpsyc.1987.01800190013002 · Cited by 114 · see citing works
Relapse in Chronic Schizophrenics following Abrupt Withdrawal of Tranquilizing Medication
Prien, R. F., Cole, J. O., & Belkin§, N. F. (1969) · The British Journal of Psychiatry · doi:10.1192/bjp.115.523.679 · Cited by 111 · see citing works
Hershon, H. I., Kennedy, P. F., & McGuire, R. (1972) · The British Journal of Psychiatry · doi:10.1192/bjp.120.554.41 · Cited by 91 · see citing works
PATTERNS OF NEUROCOGNITIVE DEFICITS AND UNAWARENESS OF ILLNESS IN SCHIZOPHRENIA
Lysaker, P. H., Lancaster, R. S., Davis, L. W., & Clements, C. A. (2003) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200301000-00007 · Cited by 72 · see citing works
Maintenance therapy of persons with schizophrenia.
Zajecka, J. M. (1996) · PubMed · Cited by 66 · see citing works
Lieberman, J. A., Alvir, J., Geisler, S., Ramos-Lorenzi, J. R., Woerner, M. G., NOVACENKO, H., Cooper, T. B., & Kane, J. M. (1994) · Neuropsychopharmacology · doi:10.1038/npp.1994.40 · Cited by 64 · see citing works
Zander, K. J., Fischer, B., Zimmer, R., & Ackenheil, M. (1981) · Psychopharmacology · doi:10.1007/bf00431099 · Cited by 61 · see citing works
Insight Changes in Acute Psychotic Episodes
Chen, E. Y. H., Kwok, C. L., CHEN, R. Y. L., & Kwong, P. (2001) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200101000-00005 · Cited by 25 · see citing works
Self-citationWithdrawal of antipsychotic drugs from chronic psychiatric patients.
Nc, R., Kondakis, X., Papanastassiou, A., et al. (1970) · PubMed · Cited by 21 · see citing works
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Social cognitive training for schizophrenia: a meta-analytic investigation of controlled research
Kurtz, M. M., & Richardson, C. L. (2012) · Schizophrenia Bulletin · doi:10.1093/schbul/sbr036 · Cited by 446 · see citing works
A Meta-Analysis of Controlled Research on Social Skills Training for Schizophrenia
Kurtz, M. M., & Mueser, K. T. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.3.491 · Cited by 425 · see citing works
Keefe, R. S. E., Buchanan, R. W., Marder, S. R., Schooler, N. R., Dugar, A., Zivkov, M., & Stewart, M. (2013) · Schizophrenia Bulletin · doi:10.1093/schbul/sbr153 · Cited by 138 · see citing works
Insight in schizophrenia: a review of etiological models and supporting research
Osatuke, K., Ciesla, J., Kasckow, J. W., Zisook, S., & Mohamed, S. (2008) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2007.08.001 · Cited by 99 · see citing works
McClure, M. M., Graff, F., Triebwasser, J., Perez-Rodriguez, M., Rosell, D. R., Koenigsberg, H., Hazlett, E. A., Siever, L. J., Harvey, P. D., & New, A. S. (2019) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2018.18030349 · Cited by 38 · see citing works
- Authors
- Chen, E. Y.-H., Hui, C. L.-M., Dunn, E. L.-W., Miao, M. Y.-K., Yeung, W.-S., Wong, C.-K., Chan, W.-F., & Tang, W.-N.
- Affiliations
- Queen Mary Hospital (CN)
- Pamela Youde Nethersole Eastern Hospital (CN)
- Corresponding author
- Chen, Eric Yu-Hai
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2005-09
- Volume
- 77
- Issue
- 1
- Pages
- 99-104
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W2117484440
- Cited by
- 123
- References
- 23
- Citations by year
- 2025: 2 · 2024: 8 · 2023: 3 · 2022: 7 · 2021: 3 · 2020: 7 · 2019: 8 · 2018: 5 · 2017: 4 · 2016: 5 · 2015: 12 · 2014: 10 · 2013: 13 · 2012: 5
- FWCI
- 3.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Funders
- University of Hong Kong
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- first-episode schizophrenia, recurrence prediction
- MeSH terms
- Adolescent, Adult, Cognition, Cognition Disorders, Female, Humans, Intelligence, Intelligence Tests, Longitudinal Studies, Male, Memory, Middle Aged, Neuropsychological Tests, Predictive Value of Tests, Prospective Studies, Recurrence, Schizophrenia, Schizophrenic Psychology, Severity of Illness Index, Verbal Behavior, Confidence Intervals, Logistic Models, Odds Ratio
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