Cognitive and clinical factors are associated with service engagement in early-phase schizophrenia spectrum disorders

We examined how neurocognition contributes to adherence with treatment in early-phase schizophrenia spectrum disorders, in context with clinical symptoms. A total of 148 patients were assessed with a broad neurocognitive test battery and clinical assessments including the Positive and Negative Syndrome Scale (PANSS); service engagement was measured by the Service Engagement Scale (SES). Patients' ability to conceptualize (measure: Wechsler Abbreviated Scale of Intelligence similarities) substantially influenced service engagement. Verbal fluency scores (measure: Delis-Kaplan Executive Functioning System semantic set shift) were significantly different between patients with high and low SES scores. Positive and excitative symptoms (measure: PANSS) contributed significantly in explaining service engagement. In the SES availability subscore, 18% of the variance resulted from PANSS positive and PANSS excitative symptoms and Wechsler Abbreviated Scale of Intelligence conceptualizing ability. Some of the relationship between cognitive deficits and clinical outcome can be mediated by patients' ability to engage in arranging appointments, thereby benefiting from professional mental health care.