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Region Hovedstaden - en del af Københavns Universitetshospital

Cognition in first-episode schizophrenia: Core deficits and effects of antipsychotics

Projekt: Typer af projekter

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The primary objectives of the present Ph.D thesis were to characterize the basic cognitive structure and profile of antipsychotic-naïve first-episode schizophrenia patients; investigate the contribution of impaired processing speed on cognition; and to examine the effects on cognition of six months of quetiapine monotherapy.
The thesis is based on a clinical longitudinal study (cohort B), in which antipsychotic-naïve, first-episode schizophrenia patients were assessed with a comprehensive neuropsychological test battery before and after six months of treatment with the second generation antipsychotic quetiapine. In order to examine the magnitude of cognitive deficits and the test-retest effects of neuropsychological tests, a matched healthy control group was also tested at baseline and after six months. Forty-eight patients and 48 healthy controls
were tested with a comprehensive neuropsychological test battery at baseline that assessed domains of verbal intelligence, processing speed, sustained attention, working memory, reasoning and problem solving,
verbal learning and memory, visual learning and memory, reaction time, and speed of executive processing.
Following this, the patients were treated with quetiapine for a period of six months, after which both patients and matched controls were retested. A total of 24 patients completed the study. The results of the baseline
study revealed that first-episode, antipsychotic-naïve patients with schizophrenia show moderate to severe deficits in all the major cognitive domains that were assessed, when compared to healthy controls. After
controlling for speed of processing, all significant differences between patients and healthy controls on cognitive domains disappeared. The results from the follow-up study, in which the patients after the initial baseline
assessments were treated for 6 months with quetiapine while the controls received no treatments, did not indicate evidence of a general cognition enhancing effects of quetiapine. In conclusion, the main results indicate
that impaired processing speed may be a substantial general component behind cognitive deficits in schizophrenia patients, and that better treatment strategies are warranted to ameliorate the cognitive deficits in schizophrenia.

ID: 32283441