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Change in neuropsychological functioning in first episode patients and at-risk mental state individuals - a longitudinal study
Project funded by own resources
Project title Change in neuropsychological functioning in first episode patients and at-risk mental state individuals - a longitudinal study
Principal Investigator(s) Riecher-Rössler, Anita
Co-Investigator(s) Stieglitz, Rolf Dieter
Gschwandtner, Ute
Pflüger, Marlon
Organisation / Research unit Bereich Psychiatrie (Klinik) / Erwachsenenpsychiatrie (Riecher-Rössler)
Project start 01.10.2008
Probable end 30.09.2012
Status Completed
Abstract

The occurrence of cognitive deficits in patients with a first episode of psychosis (FE) is well documented. There is a strong relationship between neuropsychological impairment and functional outcome, i.e. activities of daily living, social skill acquisition, social problem solving. More over, there is growing evidence for impaired neuropsychological functions even in the prodromal state of psychosis as reported by numerous early detection projects all over the world.

A remarkable number of studies considering change in neuropsychological functions in schizophrenia have been conducted in the previous years (Szöke et al., 2008). But most of the studies clearly focus on chronic patients. One of the key findings concerns the amount of improvement observed in healthy control persons versus schizophrenic patients. Almost all effect sizes, indicating improvement from baseline to reassessment, lacked statistical significance in patients but not so in healthy controls. This was cautiously interpreted as a reduced practice effect in individuals with schizophrenia. However, the significance of those longitudinal studies is limited as

(1)   there are only six studies which focus on beginning schizophrenia in terms of first episode patients and as

(2)   there is no study which focuses on the prodromal phase of schizophrenia, and as

(3)   almost all methodological approaches suffer from not taking into account reliable change, i.e. the resultant change in performance after controlling for practice effects (test sophistication), regression towards the mean and other influences arising from demographic characteristics. Therefore, the so far reported change scores of first episode patients may have been widely underestimated.

Thus, the primary aim of the study applied for is to add some more evidence of the nature of the neuropsychological impairment in the course of the beginning disease and to provide a method which is capable of delineate true change in a particular neuropsychological function from learning effects and other distorting influences. Additionally, the question arises which of both, status or change score, is superior in predicting functional outcome as assessed by the Global Assessment of Functioning (GAF) at the time of reassessment. The preconditions for reassessment based on the FEPSY study are excellent, since baseline assessment has already been carried out and the sample has been well described.

Financed by Other funds
   

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