New Study Examines Neurocognitive Impairment Trajectory in Psychosis

Psychosis usually manifests during early adulthood or adolescence. Individuals who are at risk for psychosis and psychotic conditions, including schizophrenia and bipolar, may have cognitive deficits that can be used to predict illness development. However, the study of neurocognitive capacity and executive function in psychosis has been conducted primarily on adults. Because adolescents’ neurocognitive abilities are still developing, marked differences may exist in this area for adolescents who have experienced a first episode of early onset psychosis (EOP). To explore this, Igor Bombin of the Department of Psychology at the Universidad de Oviedo in Spain recently studied a sample of adolescents within the first six months after their first psychotic episode and then conducted follow cognitive, neurological, behavioral, and psychological tests two years later.

Bombin recruited 75 teens: 23 with psychosis, 17 with bipolar, and 35 with schizophrenia and compared them to 79 non-psychotic adolescents. He found that the EOP participants had significant impairments at the beginning of the study and two years later when compared to the cognitive abilities of the control participants. Bombin found that all of the EOP participants had similar levels of impairment, regardless of their psychological condition. He looked at the two year follow-ups to see if impairment remained constant, and found that even though there were improvements in cognitive capacities for all of the participants, the control participants had significant improvements while the EOP individuals had moderate gains in all areas except for neurocognitive memory domains.

Bombin believes that these results suggest that impairment that occurs as a result of EOP is most pronounced at the first episode and little deterioration occurs thereafter. He points to the fact that the difference between levels of impairment in the EOP group and the control group, which remained constant from baseline to follow-up, supports this theory. Bombin also believes that although it may appear that EOP individuals have continued deterioration of cognitive abilities throughout adolescence and young adulthood, this may be a misconception when in fact their cognitive abilities, although stunted at time of first psychotic episode, continue to progress. It is only when their abilities are compared to the cognitive capacities of non-psychotic individuals that discrepancies imitating further impairment emerge. Bombin hopes these results will have an impact on treatment aimed at young people experiencing psychosis. He said, “Besides the theoretical aspects, these results may also have clinical derivatives, with potential roles in both neuropsychological remediation and antipsychotic treatment.” Teens that experience EOP may still have memory and executive functions in developmental stages. Targeting rehabilitation of these neurocognitive resources could aid in preventing further delays for those at risk for future psychotic episodes.

Bombin, I., et al. (2013). Neuropsychological evidence for abnormal neurodevelopment associated with early-onset psychoses. Psychological Medicine 43.4: 757-68. ProQuest. Web.

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  • Melania

    March 29th, 2013 at 3:21 PM

    Good that there are studies being done on the ones who are most likely to be affected by the most, and at a time when a real difference could possibly be made if there was the knowledge there about the causes and the things that could help to slow the progression.

  • nestor

    March 31st, 2013 at 12:37 AM

    An important finding I agree.

    But it still does not answer the question as to how to identify those at risk for psychosis. The effects after the first episode are important but a preventive mechanism could be far more useful.

  • Shayne

    April 1st, 2013 at 5:04 AM

    It really is too bad that there is not a lot of indication that this is going to happen, given that so much of the deterioration occurs around the time of the first episode. It almost feels like once that happens you will constantly be swimming against the tide, but if there were more clear cut answers early, then maybe much of that could be prevented.

  • watson

    April 1st, 2013 at 9:54 PM

    so the good news is that it is not as bad as was thought to be earlier? well that may be true. but it still does not change things for those that have suffered through psychosis. what we need are effective methods not just to treat them but also tokay e help these adolescent try and gain back as much of their abilities possible. i am sure there would be techniques to help such a situation.

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