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Predictors and Outcomes Associated with 25-Year Cognitive Decline in Psychotic Disorders
Yuan Yang1, Sean A P Clouston1, Abraham Reichenberg2
1Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY 11794, United States.
Schizophrenia Bulletin
|May 19, 2025
Summary
Faster cognitive decline in psychotic disorders predicts worse long-term outcomes, including lower remission and employment rates. Early intervention in cognitive decline may improve overall prognosis.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Psychology
Background:
- Cognitive impairment is a significant feature of psychotic disorders, impacting functional outcomes.
- Identifying predictors and outcomes of cognitive decline is crucial for improving patient prognosis.
Purpose of the Study:
- To identify predictors of cognitive decline in individuals with psychotic disorders.
- To examine the relationship between cognitive decline trajectories and long-term clinical outcomes.
Main Methods:
- Longitudinal cohort study of 400 first-admission individuals with psychotic disorders.
- Cognitive function assessed over 25 years using mixed-effects models.
- Individual cognitive trajectories used to predict 25-year clinical outcomes.
Main Results:
- No baseline predictors of cognitive decline were identified.
- Faster cognitive decline was associated with reduced odds of remission, recovery, employment, and financial independence.
- Cognitive decline correlated with poorer social functioning at 25-year follow-up.
Conclusions:
- Cognitive decline may serve as an indicator of broader illness severity in psychotic disorders.
- Interventions targeting cognitive decline could lead to widespread improvements in clinical outcomes.
- Identifying individuals with cognitive decline may guide targeted therapeutic interventions.
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