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Effects of the number of hospitalizations on cognitive function in Japanese patients with stable schizophrenia

Published online by Cambridge University Press:  04 September 2020

Hikaru Hori Open the ORCID record for Hikaru Hori [Opens in a new window] ,
Kiyokazu Atake ,
Asuka Katsuki  and
Reiji Yoshimura
Hikaru Hori*
Affiliation:
Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
Kiyokazu Atake
Affiliation:
Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
Asuka Katsuki
Affiliation:
Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
Reiji Yoshimura
Affiliation:
Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
*
*Author for correspondence: Hikaru Hori, Email: hori-h@med.uoeh-u.ac.jp
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Abstract

Background

The present study aimed to determine whether the number of hospitalizations in schizophrenia patients is associated with reduced cognitive performance, which may in turn imply that recurrences indirectly lead to a worsening in the disorder’s progression.

Methods

Cognitive performance in stable schizophrenia patients was assessed using the Brief Assessment of Cognition in Schizophrenia, Japanese-language version, on 30 patients who had not experienced any hospitalizations (G0), 57 patients who had experienced only one hospitalization (G1), 47 patients with two hospitalizations (G2), and 59 patients with three or more hospitalizations (G3).

Results

Significant differences in motor function and attention and processing speed were found between patients with G0 and those with G1. Significant differences in working memory and verbal fluency were found between patients with G1 and those with G2. Patients with G3 performed even more poorly in comparison with those with G1, showing deficits in verbal memory, working memory, executive function, and composite score. The patients with G3 displayed a greater range of impairment and demonstrated deficits in executive function compared with patients with G2. Finally, G2 and G3 performed more poorly than G0, with deficits in the various cognitive areas.

Conclusion

The number of hospitalizations predicted cognitive performance, which suggests that relapse or recurrence may have a long-term neuropsychological impact. Prospective follow-up studies must be completed to explore this effect further because better treatment adherence may have a protective effect on neurocognitive function.

Keywords

Schizophreniacognitive functionhospitalizationrecurrence
Type
Original Research
Information
CNS Spectrums , Volume 26 , Issue 6: Special Issue: Functional Neurological Disorder , December 2021 , pp. 658 - 663
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Wiersma, D, Wanderling, J, Dragomirecka, E, et al. Social disability in schizophrenia: its development and prediction over 15 years in incidence cohorts in six European centres. Psychol Med. 2000;30(5):1155–1167.CrossRefGoogle ScholarPubMed
Robinson, DG, Woerner, MG, McMeniman, M, Mendelowitz, A, Bilder, RM. Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry. 2004;161(3):473–479.CrossRefGoogle ScholarPubMed
Hegarty, JD, Baldessarini, RJ, Tohen, M, Waternaux, C, Oepen, G. One hundred years of schizophrenia: a meta-analysis of the outcome literature. Am J Psychiatry. 1994;151(10):1409–1416.Google ScholarPubMed
Gupta, S, Andreasen, NC, Arndt, S, Flaum, M, Hubbard, WC, Ziebell, S. The Iowa longitudinal study of recent onset psychosis: one-year follow-up of first episode patients. Schizophr Res. 1997;23(1):1–13.CrossRefGoogle ScholarPubMed
Bellack, AS, Morrison, RL, Wixted, JT, Mueser, KT. An analysis of social competence in schizophrenia. Br J Psychiatry: J Mental Sci. 1990;156:809–818.CrossRefGoogle Scholar
Yamauchi, K, Aki, H, Tomotake, M, et al. Predictors of subjective and objective quality of life in outpatients with schizophrenia. Psychiatry Clin Neurosci. 2008;62(4):404–411.CrossRefGoogle ScholarPubMed
Ueoka, Y, Tomotake, M, Tanaka, T, et al. Quality of life and cognitive dysfunction in people with schizophrenia. Prog Neuro-psychopharmacol Biol Psychiatry. 2011;35(1):53–59.CrossRefGoogle ScholarPubMed
Tomotake, M, Kaneda, Y, Iga, J, et al. Subjective and objective measures of quality of life have different predictors for people with schizophrenia. Psychol Rep. 2006;99(2):477–487.CrossRefGoogle ScholarPubMed
Strejilevich, SA, Palatnik, A, Avila, R, et al. Lack of extrapyramidal side effects predicts quality of life in outpatients treated with clozapine or with typical antipsychotics. Psychiatry Res. 2005;133(2–3):277–280.CrossRefGoogle ScholarPubMed
Savilla, K, Kettler, L, Galletly, C. Relationships between cognitive deficits, symptoms and quality of life in schizophrenia. Aust New Zealand J Psychiatry. 2008;42(6):496–504.CrossRefGoogle Scholar
Rocca, P, Bellino, S, Calvarese, P, et al. Depressive and negative symptoms in schizophrenia: different effects on clinical features. Compr Psychiatry. 2005;46(4):304–310.CrossRefGoogle ScholarPubMed
Rabinowitz, J, Levine, SZ, Garibaldi, G, Bugarski-Kirola, D, Berardo, CG, Kapur, S. Negative symptoms have greater impact on functioning than positive symptoms in schizophrenia: analysis of CATIE data. Schizophr Res. 2012;137(1–3):147–150.CrossRefGoogle ScholarPubMed
Jin, H, Zisook, S, Palmer, BW, Patterson, TL, Heaton, RK, Jeste, DV. Association of depressive symptoms with worse functioning in schizophrenia: a study in older outpatients. J Clin Psychiatry. 2001;62(10):797–803.CrossRefGoogle ScholarPubMed
Hofer, A, Rettenbacher, MA, Widschwendter, CG, Kemmler, G, Hummer, M, Fleischhacker, WW. Correlates of subjective and functional outcomes in outpatient clinic attendees with schizophrenia and schizoaffective disorder. Eur Arch Psychiatry Clin Neurosci. 2006;256(4):246–255.CrossRefGoogle ScholarPubMed
Fervaha, G, Foussias, G, Agid, O, Remington, G. Impact of primary negative symptoms on functional outcomes in schizophrenia. Eur Psychiatry: J Assoc Eur Psychiatrists. 2014;29(7):449–455.CrossRefGoogle Scholar
Eack, SM, Newhill, CE. Psychiatric symptoms and quality of life in schizophrenia: a meta-analysis. Schizophrenia Bull. 2007;33(5):1225–1237.CrossRefGoogle ScholarPubMed
Browne, S, Roe, M, Lane, A, et al. Quality of life in schizophrenia: relationship to sociodemographic factors, symptomatology and tardive dyskinesia. Acta Psychiatr Scand. 1996;94(2):118–124.CrossRefGoogle ScholarPubMed
Aki, H, Tomotake, M, Kaneda, Y, et al. Subjective and objective quality of life, levels of life skills, and their clinical determinants in outpatients with schizophrenia. Psychiatry Res. 2008;158(1):19–25.CrossRefGoogle ScholarPubMed
Kraus, MS, Keefe, RS. Cognition as an outcome measure in schizophrenia. Br J Psychiatry Suppl. 2007;50:s46–s51.CrossRefGoogle Scholar
Green, MF, Harvey, PD. Cognition in schizophrenia: past, present, and future. Schizophr Res Cognition. 2014;1(1):e1–e9.CrossRefGoogle ScholarPubMed
Green, MF, Kern, RS, Heaton, RK. Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophrenia Res. 2004;72(1):41–51.CrossRefGoogle ScholarPubMed
Green, MF, Kern, RS, Braff, DL, Mintz, J. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the “right stuff”? Schizophr Bull. 2000;26(1):119–136.CrossRefGoogle ScholarPubMed
Green, MF. What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry. 1996;153(3):321–330.Google Scholar
Velligan, DI, Mahurin, RK, Diamond, PL, Hazleton, BC, Eckert, SL, Miller, AL. The functional significance of symptomatology and cognitive function in schizophrenia. Schizophr Res. 1997;25(1):21–31.CrossRefGoogle Scholar
Christensen TO. The influence of neurocognitive dysfunctions on work capacity in schizophrenia patients: a systematic review of the literature. Int J Psychiatry Clin Pract. 2007;11(2):89–101.CrossRefGoogle Scholar
Hori, H, Yoshimura, R, Katsuki, A, et al. Blood biomarkers predict the cognitive effects of aripiprazole in patients with acute schizophrenia. Int J Mol Sci. 2017;18(3):568.CrossRefGoogle ScholarPubMed
Hori, H, Yoshimura, R, Katsuki, A, et al. Relationships between serum brain-derived neurotrophic factor, plasma catecholamine metabolites, cytokines, cognitive function and clinical symptoms in Japanese patients with chronic schizophrenia treated with atypical antipsychotic monotherapy. World J Biol Psychiatry. 2017;18(5):401–408.CrossRefGoogle ScholarPubMed
Hori, H, Yoshimura, R, Katsuki, A, et al. The cognitive profile of aripiprazole differs from that of other atypical antipsychotics in schizophrenia patients. J Psychiatric Res. 2012;46(6):757–761.CrossRefGoogle ScholarPubMed
Hori, H, Yoshimura, R, Katsuki, A, et al. Several prescription patterns of antipsychotic drugs influence cognitive functions in Japanese chronic schizophrenia patients. Int J Psychiatry Clin Pract. 2012;16(2):138–142.CrossRefGoogle ScholarPubMed
Hori, H, Yoshimura, R, Katsuki, A, Sugita, AI, Atake, K, Nakamura, J. Switching to antipsychotic monotherapy can improve attention and processing speed, and social activity in chronic schizophrenia patients. J Psychiatr Res. 2013;47(12):1843–1848.CrossRefGoogle ScholarPubMed
Hori, H, Katsuki, A, Atake, K, Yoshimura, R. Effects of continuing oral risperidone vs. switching from risperidone to risperidone long-acting injection on cognitive function in stable schizophrenia patients: a pilot study. Front Psychiatry. 2018;9:74CrossRefGoogle ScholarPubMed
Robinson, D, Woerner, MG, Alvir, JM, et al. Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Arch Gen Psychiatry. 1999;56(3):241–247.CrossRefGoogle ScholarPubMed
Inada, T, Inagaki, A. Psychotropic dose equivalence in Japan. Psychiatry Clin Neurosci. 2015;69(8):440–447.CrossRefGoogle ScholarPubMed
Kaneda, Y, Sumiyoshi, T, Keefe, R, Ishimoto, Y, Numata, S, Ohmori, T. Brief assessment of cognition in schizophrenia: validation of the Japanese version. Psychiatry Clin Neurosci. 2007;61(6):602–609.CrossRefGoogle ScholarPubMed
Kaneda, Y, Sumiyoshi, T, Nakagome, K, Ikezawa, S, Ohmori, TNY-F, Evaluation of cognitive functions in a normal population in Japan using the brief assessment of cognition in schizophrenia Japanese version (BACS-J). Seishin-Igaku 2013;55(2):167–175.Google Scholar
Barder, HE, Sundet, K, Rund, BR, et al. Ten year neurocognitive trajectories in first-episode psychosis. Front Human Neurosci. 2013;7:643CrossRefGoogle ScholarPubMed
Rund, BR, Melle, I, Friis, S, et al. The course of neurocognitive functioning in first-episode psychosis and its relation to premorbid adjustment, duration of untreated psychosis, and relapse. Schizophrenia Res. 2007;91(1–3):132–140.CrossRefGoogle ScholarPubMed
Pukrop, R, Schultze-Lutter, F, Ruhrmann, S, et al. Neurocognitive functioning in subjects at risk for a first episode of psychosis compared with first- and multiple-episode schizophrenia. J Clin Exp Neuropsychol. 2006;28(8):1388–1407.CrossRefGoogle ScholarPubMed
Braw, Y, Bloch, Y, Mendelovich, S, et al. Cognition in young schizophrenia outpatients: comparison of first-episode with multiepisode patients. Schizophr Bull. 2008;34(3):544–554.CrossRefGoogle ScholarPubMed
Sponheim, SR, Jung, RE, Seidman, LJ, et al. Cognitive deficits in recent-onset and chronic schizophrenia. J Psychiatric Res. 2010;44(7):421–428.CrossRefGoogle ScholarPubMed
Taylor, M, Chaudhry, I, Cross, M, et al. Towards consensus in the long-term management of relapse prevention in schizophrenia. Human Psychopharmacol. 2005;20(3):175–181.CrossRefGoogle Scholar
Almond, S, Knapp, M, Francois, C, Toumi, M, Brugha, T. Relapse in schizophrenia: costs, clinical outcomes and quality of life. Br J Psychiatry: J Mental Sci. 2004;184:346–351.CrossRefGoogle ScholarPubMed
van Haren, NE, Hulshoff Pol, HE, Schnack, HG, et al. Focal gray matter changes in schizophrenia across the course of the illness: a 5-year follow-up study. Neuropsychopharmacol: Official Publ Am College Neuropsychopharmacol. 2007;32(10):2057–2066.CrossRefGoogle ScholarPubMed
Andreasen, NC, Liu, D, Ziebell, S, Vora, A, Ho, BC. Relapse duration, treatment intensity, and brain tissue loss in schizophrenia: a prospective longitudinal MRI study. Am J Psychiatry. 2013;170(6):609–615.CrossRefGoogle ScholarPubMed
Burton, CZ, Vella, L, Harvey, PD, Patterson, TL, Heaton, RK, Twamley, EW. Factor structure of the MATRICS consensus cognitive battery (MCCB) in schizophrenia. Schizophr Res. 2013;146(1–3):244–248.CrossRefGoogle Scholar
Dickinson, D, Ramsey, ME, Gold, JM. Overlooking the obvious: a meta-analytic comparison of digit symbol coding tasks and other cognitive measures in schizophrenia. Arch Gen Psychiatry. 2007;64(5):532–542.CrossRefGoogle Scholar
Rodriguez-Sanchez, JM, Crespo-Facorro, B, Gonzalez-Blanch, C, Perez-Iglesias, R, Vazquez-Barquero, JL. Cognitive dysfunction in first-episode psychosis: the processing speed hypothesis. Br J Psychiatry Suppl. 2007;51:s107–s110.CrossRefGoogle ScholarPubMed
Keefe, RS, Seidman, LJ, Christensen, BK, et al. Long-term neurocognitive effects of olanzapine or low-dose haloperidol in first-episode psychosis. Biol Psychiatry. 2006;59(2):97–105.CrossRefGoogle ScholarPubMed
Zhang, JP, Gallego, JA, Robinson, DG, Malhotra, AK, Kane, JM, Correll, CU. Efficacy and safety of individual second-generation vs. first-generation antipsychotics in first-episode psychosis: a systematic review and meta-analysis. Int J Neuropsychopharmacol. 2013;16(6):1205–1218.CrossRefGoogle ScholarPubMed
Dickerson, F, Schroeder, J, Stallings, C, et al. A longitudinal study of cognitive functioning in schizophrenia: clinical and biological predictors. Schizophrenia Res. 2014;156(2–3):248–253.CrossRefGoogle ScholarPubMed
Klingberg, S, Wittorf, A, Sickinger, S, Buchkremer, G, Wiedemann, G. Course of cognitive functioning during the stabilization phase of schizophrenia. J Psychiatr Res. 2008;42(4):259–267.CrossRefGoogle ScholarPubMed
Hori, H, Yoshimura, R, Katsuki, A, Atake, K. Plasma levels of 3-methoxy-4-hydroxyphenylglycol levels, number of hospitalization and cognitive function predicts the cognitive effect of atypical antipsychotic monotherapy in patients with acute schizophrenia. Int Clin Psychopharmacol. 2020;35(2):89–97.CrossRefGoogle ScholarPubMed
Radhakrishnan, R, Kiluk, BD, Tsai, JA. Meta-analytic review of non-specific effects in randomized controlled trials of cognitive remediation for schizophrenia. Psychiatr Quart. 2016;87(1):57–62.CrossRefGoogle Scholar
Firth, J, Stubbs, B, Rosenbaum, S, et al. Aerobic exercise improves cognitive functioning in people with schizophrenia: a systematic review and meta-analysis. Schizophr Bull. 2017;43(3):546–556.Google ScholarPubMed