Is cognitive performance associated with anxiety and depression in first-episode psychosis?

In first-episode psychosis (FEP), symptoms of anxiety and depression are common. We examined whether cognitive performance is associated with these clinical measures in FEP during a one-year follow-up.

Young adults with non-affective FEP (n = 52) were assessed two months after their first psychiatric contact for psychosis. Matched controls (n = 62) were administered a baseline assessment. 32 FEP subjects and 44 controls were assessed again at a one-year follow-up. In both assessments, a broad neuropsychological test battery was administered. Clinical evaluation was done with the Brief Psychiatric Rating Scale. Cross-sectional correlations were calculated at both time points. Cognitive test scores were used as independent variables in regression models, predicting both baseline and follow-up symptom levels.

At baseline, better performance especially in verbal memory and executive functioning was associated with elevated anxiety symptoms in FEP. In addition, better performance especially in verbal working memory was associated with depression. A year later, better cognitive performance was no longer associated with affective symptoms.

Small sample sizes are a limitation.

In the FEP group, higher cognitive performance associated with affective symptoms. Right after getting severely ill, anxiety and depression may be a part of normal adaptive reactions to the situation and markers of an intact cognitive performance. This association seems to cease during the year following the FEP.