Entire duration of active psychosis and neurocognitive performance in first-episode non-affective psychosis

Early Interv Psychiatry. 2021 Oct;15(5):1266-1275. doi: 10.1111/eip.13077. Epub 2020 Nov 26.


Aim: To explore if the entire duration of active psychosis (DAP) is related to neurocognitive performance at baseline and at 3-year follow-up in patients with first episode psychosis (FEP).

Methods: DAP was estimated for 481 FEP patients. A neuropsychological battery was administered to measure neurocognitive specific domains, and a global indicator of neurocognitive impairment (global deficits score, GDS) was calculated. According to the DAP quartiles, four subgroups were formed, and these were compared. In addition, a logistic regression analysis was carried out to predict neurocognitive impairment at 3-year follow-up.

Results: FEP patients with the longest DAP (more than 18.36 months) presented a more severe global neurocognitive impairment evidenced in their GDS, both at baseline (F = 5.53; p˂ .01) and at 3-year follow-up (F = 4.16; p˂ .01). Moreover, a subgroup of participants with DAP between 7.40 and 18.36 months showed a specific attentional decline over the 3-year follow-up (F = 3.089; p˂ .05).The logistic regression model showed that sex (Wald = 7.29, p < .010), premorbid adjustment (Wald = 7.24, p < .010), attention (Wald = 12.10, p < .001), verbal memory (Wald = 16.29, p < .001) and visual memory (Wald = 9.41, p < .010) were significant predictors of neurocognitive impairment 3 years after the FEP. The variables composing the DAP were not significant predictors in this model.

Conclusions: DAP seems to be related to global neurocognitive impairment in FEP patients. These findings contribute in several ways to our understanding of the effects of active psychosis on the brain, and provide the basis for future research.

Keywords: cognition; cognitive impairment; neuropsychology; psychosis; psychotic disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attention
  • Cognition Disorders*
  • Humans
  • Memory
  • Neuropsychological Tests
  • Psychotic Disorders* / complications
  • Psychotic Disorders* / diagnosis