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Prognostic value of cognitive functioning for global functional recovery in first-episode schizophrenia

Published online by Cambridge University Press:  15 September 2009

C. González-Blanch ,
R. Perez-Iglesias ,
G. Pardo-García ,
J. M. Rodríguez-Sánchez ,
O. Martínez-García ,
J. L. Vázquez-Barquero  and
B. Crespo-Facorro
C. González-Blanch*
Affiliation:
Psychiatry Research Unit of Cantabria, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University Hospital ‘Marqués de Valdecilla’, Santander, Spain
R. Perez-Iglesias
Affiliation:
Psychiatry Research Unit of Cantabria, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University Hospital ‘Marqués de Valdecilla’, Santander, Spain
G. Pardo-García
Affiliation:
Psychiatry Research Unit of Cantabria, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University Hospital ‘Marqués de Valdecilla’, Santander, Spain
J. M. Rodríguez-Sánchez
Affiliation:
Psychiatry Research Unit of Cantabria, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University Hospital ‘Marqués de Valdecilla’, Santander, Spain
O. Martínez-García
Affiliation:
Psychiatry Research Unit of Cantabria, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University Hospital ‘Marqués de Valdecilla’, Santander, Spain
J. L. Vázquez-Barquero
Affiliation:
Psychiatry Research Unit of Cantabria, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University Hospital ‘Marqués de Valdecilla’, Santander, Spain
B. Crespo-Facorro
Affiliation:
Psychiatry Research Unit of Cantabria, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University Hospital ‘Marqués de Valdecilla’, Santander, Spain
*
*Address for correspondence: Dr C. González-Blanch, Hospital Universitario ‘Marqués de Valdecilla’, Unidad de Investigación en Psiquiatría de Cantabria, Planta 2a, Edificio 2 de Noviembre Avda, Valdecilla s/n, 39008, Santander, Spain. (Email: cgblanch@terra.es)
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Abstract

Background

It has become widely accepted that cognitive deficits in schizophrenia are related to functional outcome. However, it remains to be seen whether these associations are relevant for predicting which cases will have a global functional recovery. In this study, we attempt to determine whether global functional recovery (integrating social and occupational outcomes) after first-episode schizophrenia (FES) can be predicted by cognitive variables.

Method

A total of 131 FES patients with functional deficits (n=97) and functional recovery (n=34) as determined at 1-year follow-up were examined. Neuropsychological, sociodemographic, pre-morbid and clinical data at baseline were analysed using independent groups comparisons and a logistic regression method.

Results

Sustained attention and negative symptoms emerged as significant predictors of good global functional outcome. Although the model revealed a high accuracy (91%) in the classification of patients with functional deficits, it was unacceptably low (26%) in the classification of patients with global functional recovery.

Conclusions

The limitations found in the prediction of a favourable global functional outcome may well be an indication for a need to address the role of other factors not commonly included in longitudinal studies of long-term outcomes in schizophrenia.

Keywords

Cognitive deficitsfirst episodepredictorsrecoveryschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 6 , June 2010 , pp. 935 - 944
Copyright
Copyright © Cambridge University Press 2009

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