Untreated Initial Psychosis: Relation to Cognitive Deficits and Brain Morphology in First-Episode Schizophrenia

• DOI: 10.1176/appi.ajp.160.1.142
• Publication Date: 2002-12-27T15:22:39Z
• Authors: Beng-Choon Ho; Daniel Alicata; Julianna Ward; David J. Moser; Daniel S. O’Leary; Stephan Arndt; Nancy C. Andreasen
• Keywords: Neurocognitive; Schizophreniform disorder

OBJECTIVE: Studies of patients experiencing their first episode psychosis have demonstrated that they typically remain undiagnosed and untreated for 1–2 years. It has been postulated prolonged may serious effects: poor response to neuroleptic medications, clinical outcomes, direct neurotoxicity. This study investigated the relationships between duration initial neurocognitive functioning high-resolution imaging brain measurements. METHOD: A total 156 subjects with DSM-IV schizophrenia, schizophreniform disorder, or schizoaffective disorder were evaluated during psychosis. Measurements included nine domains functioning, volumetric measures tissue, gray white matter, CSF, surface anatomy. RESULTS: The mean was 74.3 weeks. Correlations measurements, anatomy measurements weak; none reached statistical significance. When group divided on basis median psychosis, there again no significant differences groups long short except two (verbal memory cortical sulcal depth). CONCLUSIONS: absence strong correlations suggests toxic neural effects. These results suggest large-scale initiatives designed prevent injury through early intervention in prepsychotic phase be based incorrect assumptions neurotoxicity cognitive deterioration avoided. Nevertheless, treatment is justified because it reduces suffering.