Short-term development of neurocognition in early-stage schizophrenia with predominant negative symptoms

Abstract

Background: In order to explore the short-term neurocognitive development of early-stage patients with negative symptom-dominant (NSD) schizophrenia.

Methods: This large-scale longitudinal follow-up study of patients with early-stage schizophrenia were recruited from the Brain Hospital of Nanjing Medical University and Second Xiangya Hospital of Central South University. Neurocognition was assessed using the MATRICS Consensus Cognitive Battery (MCCB) in schizophrenia at baseline and 8-week follow-up. Symptom profiles were determined using the Positive and Negative Symptoms Scale (PANSS), and NSD was defined as those PANSS Negative Subscale Score ≥24, while the remaining subjects are defined as non-negative symptom-dominant (N-NSD).

Results: All dimensions of cognitive function were significantly lower in the NSD than in the N-NSD group at baseline (All P < 0.05). After 8 weeks of follow-up, patients in NSD group showed no significant differences from the N-NSD group in any dimension of neurocognition, except for social cognition, N-NSD group still showed superior cognitive performance compared to NSD group(F = 4.906; P = 0.028; Cohen's d = 0.026). Correlation analysis shows cognitive impairment was positively associated with the severity of negative symptoms over time (All P < 0.05). The changes of PANSS scores and several neurocognitive domains differ significantly among different antipsychotic medications.

Conclusion: Our results reveal a distinct clinical subtype in patients with schizophrenia defined by prominent negative symptoms and cognitive deficits; however, this group does not exhibit a unique trajectory in short-term neurocognitive development. Which could advance our understanding of the relationship between cognition and clinical characteristics, and provides guidance for personalized intervention strategies.

Keywords: Cognition; Development; Negative symptoms; Schizophrenia.