Neuropsychological and functional outcomes in recent-onset major depression, bipolar disorder and schizophrenia-spectrum disorders: a longitudinal cohort study
Open accessAbstract
Functional disability is the lead contributor to burden of mental illness. Cognitive deficits frequently limit functional recovery, although whether changes in cognition and disability are longitudinally associated in recent-onset individuals remains unclear. Using a prospective, cohort design, 311 patients were recruited and assessed at baseline. One hundred and sixty-seven patients met eligibility criteria (M=21.5 years old, s.d.=4.8) and returned for follow-up (M=20.6 months later, s.d.=7.8). Two-hundred and thirty participants were included in the final analysis, comprising clinically stable patients with major depression ( n =71), bipolar disorder (BD; n =61), schizophrenia-spectrum disorders ( n =35) and 63 healthy controls. Neuropsychological functioning and self-rated functional disability were examined using mixed-design, repeated-measures analysis, across diagnoses and cognitive clusters, covarying for relevant confounds. Clinical, neuropsychological and functional changes did not differ between diagnoses (all P >0.05). Three reliable neuropsychological subgroups emerged through cluster analysis, characterized by psychomotor slowing, improved sustained attention, and improved verbal memory. Controlling for diagnosis and changes in residual symptoms, clusters with improved neuropsychological functioning observed greater reductions in functional disability than the psychomotor slowing cluster, which instead demonstrated a worsening in disability ( P <0.01). Improved sustained attention was independently associated with greater likelihood of follow-up employment ( P <0.01). Diagnosis of BD uniquely predicted both follow-up employment and independent living. Neuropsychological course appears to be independently predictive of subjective and objective functional outcomes. Importantly, cognitive phenotypes may reflect distinct pathophysiologies shared across major psychiatric conditions, and be ideal targets for personalized early intervention.
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Improved cognitive function has been associated with higher rates of employment at follow-up in a variety of psychiatric illnesses, including major depressive disorder.
“Longitudinally, improved cognitive function has been associated with higher rates of employment at follow-up in a variety of psychiatric illnesses, including MDD [23].”
From Wearable technology for high-frequency cognitive and mood assessment in major depressive disorder: longitudinal observational study (2019) · cites this paper as [23]
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Self-citation
- Authors
- Lee, R. S. C., Hermens, D. F., Naismith, S. L., Lagopoulos, J., Jones, A., Scott, J., Chitty, K. M., White, D., Robillard, R., Scott, E. M., & Hickie, I. B.
- Affiliations
- The University of Sydney (AU)
- Newcastle University (GB)
- Corresponding author
- Lee, R S C
- ORCID
- Venue
- Translational Psychiatry
- Published
- 2015-04-28
- Volume
- 5
- Issue
- 4
- Pages
- e555-e555
- ISSN
- 2158-3188 (ISSN-L)
- PMC
- PMC4462613
- OpenAlex
- W1983351472
- Cited by
- 134
- References
- 73
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 6 · 2023: 11 · 2022: 15 · 2021: 12 · 2020: 14 · 2019: 22 · 2018: 13 · 2017: 13 · 2016: 10 · 2015: 1
- FWCI
- 10.02
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Translational Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ResearchOnline@ND (The University of Notre Dame) (submittedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- The Sydney eScholarship Repository (The University of Sydney) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Directorate for Education and Human Resources
- Fonds de Recherche du Québec - Santé
- Medical Research Council
- National Health and Medical Research Council (464914, 1008117, 566529, 1061043)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- recent-onset depression, bipolar disorder, schizophrenia spectrum disorders, functional disability, neuropsychological performance, cognitive impairment, sustained attention, psychomotor retardation, verbal memory, employment effects, independent living, cognitive phenotypes, early intervention, longitudinal change
- MeSH terms
- Adolescent, Adult, Bipolar Disorder, Cognition Disorders, Depressive Disorder, Major, Major Depressive Disorder, Disability Evaluation, Female, Humans, Longitudinal Studies, Male, Memory, Neuropsychological Tests, Prospective Studies, Psychomotor Disorders, Schizophrenia, Schizophrenic Psychology, Cohort Studies, Cluster Analysis, Logistic Models, Case-Control Studies, Recovery of Function, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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