Abstract
To add to the open question whether cognitive impairments predict clinical outcome in schizophrenia, a sample of 125 first episode patients was assessed at the onset and over one year of controlled long-term treatment within a study of the German Research Network on Schizophrenia. No relapse according to predefined criteria occurred within the first year, but a total of 29 patients fulfilled post-hoc criteria of “clinical deterioration”. Impairments in cognitive functioning assessed by the Trail-Making Test B at the onset of long-term treatment differentiated between patients with vs. without later clinical deterioration and proved to be a significant predictor of the clinical course in a regression analysis outperforming initial clinical status as predictor. However, low sensitivity (72%) and specificity (51%) limit possibilities of a transfer to individual predictions. As a linear combination of neuropsychological and psychopathological variables obtained highest predictive validity, such a combination may improve the prediction of the course of schizophrenic disorders and may ultimately lead to a more efficient and comprehensive treatment planning.
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Acknowledgment
This study is part of the German Research Network on Schizophrenia and was funded by the German Federal Ministry of Education and Research (BMBF grants 01GI9932, 01GI0232, and 01G0532). The authors are much obliged to the members of the German Study Group on First-Episode Schizophrenia for all their contributions. The German Study Group on First-Episode Schizophrenia: W.G., W.W., M.R., J.B., Martina von Wilmsdorf, Robert Krohmer (Düsseldorf, Germany); A.K. (Offenbach, Germany); Matthias Eickhoff (Warstein/Lippstadt, Germany); H.-J.M., Markus Jäger (Munich, Germany); S.K., Gerd Buchkremer, Michael Mayenberger, (Tuebingen, Germany); Paul Hoff, Frank Schneider (Aachen, Germany; recruitment until June 2002); Wolfgang Maier, Kai-Uwe Kühn, Matthias Lemke, Beate Johannwerner (Bonn, Germany); Isabella Heuser, Maria C. Jockers-Scherübl (Berlin, Germany); Joachim Klosterkötter, Andreas Bechdolf, Wolfgang Huff (Cologne, Germany); Markus Gastpar, Stefan Bender, Volker Reissner (Essen, Germany); Eckhart Rüther, Peter Falkai, Detlef Degner, Andrea Schmitt (Goettingen, Germany); Heinrich Sauer, Ralf Schlösser, Gerd Wagner (Jena, Germany); Fritz A. Henn, Heinz Häfner, Kurt Maurer, Hans J. Salize (Mannheim, Germany); Lutz G. Schmidt (Mainz, Germany; recruitment until February 2002). Conflict of interest disclosure W.G. has received consultation fees (including scientific advisory boards) from Janssen Cilag, Lilly Germany, Lundbeck GmbH, the Lundbeck Foundation, Novartis and Wyeth Pharma. W.G. has received research grants from Astra Zeneca, Bristol Myers Squibb, Eli Lilly Foundation, Janssen Cilag and Lilly Germany. W.G. is or was a member of the Speaker's Bureau of Astra Zeneca, Bristol Myers Squibb, Janssen-Cilag, Lilly Germany, Lundbeck GmbH, Lundbeck Institute, Novartis and Wyeth Pharma. H.-J. M. has received grants or is a consultant for and on the Speakership Bureaus of AstraZeneca, Bristol-Myers Squibb, Eisai, Eli Lilly, GlaxoSmithKline, Janssen Cilag, Lundbeck, Merck, Novartis, Organon, Pfizer, Sanofi-Aventis, Sepracor, Servier and Wyeth. A.K. is a member of the Advisory Boards for AstraZeneca and Otsuka Pharma, and is or was a member of the Speaker Bureau for AstraZeneca, Janssen-Cilag, Lilly Germany, and Novartis Pharma. W.W. was a member of the Speaker Bureau for Janssen-Cilag and Lilly Germany. J.B., M.R., L.F., M.W., and S.K. report no financial or other relationships with a commercial organization including those sponsoring or organizing the 2007 congress of the German Society of Psychiatry, Psychotherapy and Nervous Diseases (DGPPN) that might pose a conflict of interest.
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Wölwer, W., Brinkmeyer, J., Riesbeck, M. et al. Neuropsychological impairments predict the clinical course in schizophrenia. Eur Arch Psychiatry Clin Neurosci 258 (Suppl 5), 28–34 (2008). https://doi.org/10.1007/s00406-008-5006-2
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DOI: https://doi.org/10.1007/s00406-008-5006-2