Cognitive markers related to long-term remission status in Schizophrenia Spectrum Disorders

Cognitive impairment is an established feature of schizophrenia. From a cross-sectional perspective, studies have revealed associations between cognition and remission. Few studies have examined this relationship longitudinally. Here we examine which cognitive domains might be related to long-term remission and symptomatic severity. The present study followed 173 outpatients with schizophrenia for five years, divided into groups based on long-term remission status and symptomatic severity, assessed with the Positive and Negative Syndrome Scale. Cognitive functioning was assessed at baseline, with tests of vigilance, executive functions, processing speed, memory and learning, working memory, and premorbid functioning. Cognitive domains related to long-term remission status were executive functions, working memory, and premorbid functioning. The most prominent cognitive differences were found between the group in stable remission with minimal symptoms, and the non-remission group, the first group demonstrating better cognitive functioning. The study highlights the role of premorbid functioning as a cognitive feature in the prediction of long-term remission. It also indicates the possibility of viewing specific cognitive domains as markers for clinical outcome, highlighting the value of early assessment of cognition. In summary, a certain cognitive profile, in coexistence with long-term non-remission, suggests poorer outcome. Hence, this group is in need of increased support.