Cognitive impairment is recognized as an important feature of psychosis in its early stages and is a determinant of prognosis and management of these disorders.

To test the cognitive functions in first psychotic episode in patients with disorders of schizophrenia, schizoaffective disorder, bipolar disorder and depression with psychotic disorder and to compare them to controls.

The study included 254 patients diagnosed according to Diagnostic and Statistical criteria of Mental disorders, 4th edition (91 schizophrenics, 21 with schizoaffective disorder, 107 with bipolar disorder and 31 with psychotic depression) and experiencing their first psychotic episode. Seventy healthy volunteers matched as regards age and sex with patients were used as controls. All are subjected to cognitive evaluation by Trail Making Test, part B, Wisconsin card sorting test 128, Benton Visual Retention Test and Wechsler Adult Intelligence Test.

All patients showed significant cognitive deterioration in all tests compared to control group. On comparing patients to each other, there was no significant difference between schizophrenics and patients with bipolar disorder, but both showed marked deterioration in comparison to depressive group.

Cognitive impairments are present in early stages of psychosis and need careful assessment and management.