Neuropsychological course in the prodrome and first episode of psychosis: findings from the PRIME North America Double Blind Treatment Study

Schizophr Res. 2008 Oct;105(1-3):1-9. doi: 10.1016/j.schres.2008.07.008. Epub 2008 Sep 6.

Abstract

Objective: There is uncertainty regarding the onset timing of the cognitive deficiencies of schizophrenia. We investigated whether conversion to psychosis and/or olanzapine altered the neuropsychological course of subjects within the first-ever double blind medication study of the putative schizophrenia first episode prodrome.

Method: Sixty participants in a double blind trial of olanzapine as a treatment for putative prodromal states were assessed at entry (pre-randomization), and again at 6 and 12 months (if they remained non-psychotic), or at any of these points prior to psychosis followed by post-psychosis and 6 months post-psychosis assessments.

Results: Participants who converted to psychosis did not differ from placebo non-converters in pre-randomization global neuropsychological status. Early converters did not differ from later converters in entry neuropsychological status. Subjects who converted after 6 months did not show neuropsychological declines during the initial, pre-psychosis, 6 months. Neuropsychological course did not differ between converters to psychosis and non-converters, or between olanzapine and placebo-assigned subjects.

Conclusions: Neither the onset of frank psychosis nor olanzapine treatment of the prodrome significantly alters neuropsychological course in persons considered to be at high risk at their initial (pre-psychosis) assessment. These findings suggest that the neuropsychological deficiencies associated with psychotic conditions largely pre-exist the first frank psychotic episode.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antipsychotic Agents / pharmacology
  • Antipsychotic Agents / therapeutic use
  • Benzodiazepines / pharmacology
  • Benzodiazepines / therapeutic use
  • Cognition / drug effects
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / epidemiology
  • Cognition Disorders / psychology
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Neuropsychological Tests / statistics & numerical data*
  • North America
  • Olanzapine
  • Placebos
  • Psychiatric Status Rating Scales
  • Schizophrenia / diagnosis*
  • Schizophrenia / drug therapy
  • Schizophrenia / epidemiology
  • Schizophrenic Psychology*
  • Treatment Outcome

Substances

  • Antipsychotic Agents
  • Placebos
  • Benzodiazepines
  • Olanzapine