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Affective versus non-affective first episode psychoses: A longitudinal study.
C Torrent1, M Reinares1, A Martinez-Arán1
1Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
Journal of Affective Disorders
|June 15, 2018
Summary
Clinical and neurocognitive differences in first psychotic episodes (FEP) were observed at baseline, impacting functional outcomes. Executive function deficits and symptom severity predicted poorer psychosocial functioning in FEP patients.
Area of Science:
- Psychiatry and Neuroscience
- Clinical Psychology
Background:
- First psychotic episodes (FEP) present with diverse clinical and neuropsychological profiles.
- Distinguishing between affective and non-affective psychoses is crucial for understanding disease trajectories.
- Longitudinal studies are essential for tracking changes and identifying predictors of functional outcome.
Purpose of the Study:
- To compare clinical, neuropsychological, and functional differences in affective versus non-affective psychoses at baseline and two-year follow-up.
- To identify clinical and neuropsychological predictors of psychosocial functioning in patients with first psychotic episodes.
Main Methods:
- Subanalysis of a multicentre, naturalistic, longitudinal prospective study.
- Inclusion of 192 patients with first psychotic episodes (142 non-affective, 50 affective).
- Statistical analyses included t-tests, ANOVAs, Pearson correlations, and regression analyses.
Main Results:
- Significant baseline differences between affective and non-affective psychoses in executive function (WCST), premorbid adjustment (PAS), family history, negative (PANSS), and manic symptoms (YMRS).
- At two-year follow-up, differences persisted in PANSS subscales and depressive symptoms (MADRS).
- For the entire sample, PANSS total score and verbal fluency (FAS/COWAT) predicted 41% of the variance in functioning.
Conclusions:
- Clinical and neurocognitive differences present at baseline diminish over two years.
- Impaired executive functions and greater symptom severity (PANSS) at baseline predict poorer functional outcomes in first psychotic episodes.
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