Neurocognition as Predictor for Social and Role Functioning in First-Episode Schizophrenia During Eight Years of Follow-ups

Schizophrenia is a debilitating mental illness with severe consequences for patients and society. However, a large degree of heterogeneity is apparent. Research on First-Episode Schizophrenia (FES) shows better outcome than previous research on older cohorts. A wide spectrum of functioning is observed, and neurocognition has emerged as a potential predictor. We investigate if neurocognitive domains predict functioning throughout eight years in FES patients, and whether the neurocognitive predictors in short-term functional change are equal to those for late-term. The candidate was provided with data from the Oslo Schizophrenia Recovery Study (OSR). Methods: Neurocognitive domains of 28 FES patients recruited for the OSR were assessed using the MATRICS Consensus Cognitive Battery. Functioning was assessed with the global functioning: social and role measures. Assessments were done at baseline, six months, 12 months, and annually thereafter. The cut-off between short- and long-term was somewhat arbitrarily set at four years. The candidate performed all statistical analysis, with growth curve modelling as the main procedure. Results: Social and role functioning improved as an effect of time with substantial variance at baselines and for the slopes. The effect of time was greater on role functioning. Several neurocognitive domains predicted both functioning measures at the intercept. No significant interaction effects with time emerged throughout the eight years. A significant interaction effect with time on social functioning emerged for attention in short-term. Conclusion: FES patients seem to substantially improve in functioning, especially for role functioning and in the first years of illness. However, there is great heterogeneity in this improvement, where a few patients are predicted to functionally worsen with time. It seems that neurocognition predicts functioning, but not functional change throughout eight years. Attention seems to affect change in social functioning throughout the first four years. Our findings can be used to facilitate hope and optimism and to tailor treatment for FES patients. Future research ought to investigate the mechanisms behind our findings and how neurocognition beyond baseline is associated with functioning