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Effects of socioeconomic status in cognition of people with schizophrenia: results from a Latin American collaboration network with 1175 subjects

Published online by Cambridge University Press:  23 June 2021

Letícia Sanguinetti Czepielewski*
Affiliation:
Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Programa de Pós-Graduação em Psicologia, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
Luz Maria Alliende
Affiliation:
Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
Carmen Paz Castañeda
Affiliation:
Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
Mariana Castro
Affiliation:
Research Group on Neurosciences as applied to Abnormal Behaviour (INAAC Group), FLENI-CONICET Neurosciences Institute, Buenos Aires, Argentina Department of Psychiatry and Mental Health (Fleni Teaching Unit) and Department of Physiology, University of Buenos Aires School of Medicine, Buenos Aires, Argentina
Salvador M. Guinjoan
Affiliation:
Department of Psychiatry and Mental Health (Fleni Teaching Unit), University of Buenos Aires School of Medicine. CONICET, Buenos Aires, Argentina
Raffael Massuda
Affiliation:
Departamento de Psiquiatria, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
Arthur A. Berberian
Affiliation:
Universidade Federal de São Paulo, São Paulo, Brazil
Ana Olivia Fonseca
Affiliation:
Universidade Federal de São Paulo, São Paulo, Brazil
Ary Gadelha
Affiliation:
Programa de Esquizofrenia, da Escola Paulista de Medicina Universidade Federal de São Paulo (PROESQ-EPM/UNIFESP). Laboratory of Integrative Neuroscience (LINC), Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
Rodrigo Bressan
Affiliation:
Universidade Federal de São Paulo, São Paulo, Brazil
Marisa Crivelaro
Affiliation:
PROJESQ (Programa de Esquizofrenia), Instituto de Psiquiatria do HCFMUSP, São Paulo, Brazil
Mario Louzã
Affiliation:
PROJESQ (Programa de Esquizofrenia), Instituto de Psiquiatria do HCFMUSP, São Paulo, Brazil
Juan Undurraga
Affiliation:
Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
Alfonso González-Valderrama
Affiliation:
Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile School of Medicine, Universidad Finis Terrae, Santiago, Chile
Rubén Nachar
Affiliation:
Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile School of Medicine, Universidad Finis Terrae, Santiago, Chile
Rodrigo R. Nieto
Affiliation:
University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile Department of Neuroscience, Faculty of Medicine, Universidad de Chile, Santiago, Chile
Cristian Montes
Affiliation:
University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
Hernan Silva
Affiliation:
University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
Álvaro I. Langer
Affiliation:
Instituto de Estudios Psicológicos, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile Center for Interdisciplinary Studies on the Nervous System (CISNe), Universidad Austral de Chile, Valdivia, Chile Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
Carlos Schmidt
Affiliation:
Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile Brain, Cognition and Behavior PhD Program, University of Barcelona, Barcelona, Spain
Rocío Mayol-Troncoso
Affiliation:
University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
Ana M. Díaz-Zuluaga
Affiliation:
Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
Johanna Valencia-Echeverry
Affiliation:
Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
Carlos López-Jaramillo
Affiliation:
Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
Rodolfo Solís-Vivanco
Affiliation:
Laboratory of Neuropsychology, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
Francisco Reyes-Madrigal
Affiliation:
Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
Camilo de la Fuente-Sandoval
Affiliation:
Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
Nicolás A. Crossley
Affiliation:
Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile Biomedical Imaging Center and Center for Integrative Neuroscience, Pontificia Universidad Católica de Chile, Santiago, Chile Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
Clarissa S. Gama
Affiliation:
Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
*
Author for correspondence: Leticia Sanguinetti Czepielewski, E-mail: leticia.czepielewski@ufrgs.br

Abstract

Background

Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls.

Methods

We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments.

Results

Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology.

Conclusions

Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Effects of socioeconomic status in cognition of people with schizophrenia: results from a Latin American collaboration network with 1175 subjects
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