Cognitive factors in long term outcome of first episode psychosis

Amresh Shrivastava, Megan Johnston, Nilesh Shah , Meghana Thakar , and Larry Stitt

a Excecutive Director , Mental Health Foundation of India (PRERANA Charitable trust) and Silver Mind Hospital, 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602, Currently: Assistant Professor of Psychiatry, The University of western Ontario, & associate Scientist, Lawson Health Research Institute, London, Ontario,Canada, E Mail : amresh.edu@gmail.com b Professor of Psychiatry LTMG Hospital, University of Mumbai, Sion, Mumbai, Maharashtra, India 400 022 c Clinical psychologist, Silver Mind Hospital, Mumbai,India d Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada N6A 5C1 e Research Office, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada N6A 5C1

*Corresponding author. Tel.: +1-519-631-8510; Fax: +1-519-631-2512. E-mail address: dr.amresh@gmail.com (A. Shrivastava). Present address: Regional Mental Health Care, 467 Sunset Drive, St. Thomas, Ontario, Canada N5H 3V9.

One negative outcome associated with schizophrenia is a deterioration of cognitive functioning. The existing research on cognitive functioning in first-episode schizophrenia suggests that cognitive deficits may be present quite early on in the illness. Less is known about what happens to cognitive abilities in the years following a diagnosis of first-episode schizophrenia. The present study examined the cognitive function of individuals first diagnosed with schizophrenia and then again ten years later to examine changes in cognitive functioning across this time period. Individuals diagnosed with first-episode schizophrenia, who ten years later were classified as "recovered," had their cognitive functioning assessed both at the time of diagnosis and at the ten year follow-up. Our results indicate deterioration in some abilities at baseline and a decline of cognitive abilities in the group of clinically recovered patients. Visuo-spatial memory, working memory and executive functioning were shown to decrease in the ten years of treatment following diagnosis and many individuals classified as "recovered" still demonstrate abnormal cognitive functioning. These findings suggest that cognitive functions should be focused on to a much greater degree in current treatment methods.