Neuropsychological, clinical and cognitive insight predictors of outcome in a first episode psychosis study

Jennifer A. O'Connor*, Benjamin Wiffen, Marta DiForti, Laura Ferraro, Candice Joseph, Anna Kolliakou, Stefania Bonaccorso, Robin M. Murray, Anthony S. David

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

42 Citations (Scopus)

Abstract

The outcome of first episode psychosis (FEP) is highly variable and difficult to predict. We studied prospectively the impact of poor insight and neuropsychological deficits on outcomes in a longitudinal cohort of 127 FEP patients. Participants were assessed on 5 domains of cognitive function and 2 domains of insight (clinical and cognitive). At 12 months, patients were assessed again for symptom severity and psychosocial function. Regression analyses revealed that cognitive insight (a measure of self-reflectiveness and self-certainty) was the best baseline predictor of overall psychopathology at 12 months whereas executive function performance at admission to the study indicated later severity of negative symptoms. Other neuropsychological and insight measures were poor predictors of psychosocial function at 1 year. The results suggest that specific neuropsychological and insight factors have separate predictive capacities indicating that they are distinct psychological processes in psychosis. Cognitive insight proved to be a useful prognostic indicator, and should be considered for future studies and as a potential focus for treatment.

Original languageEnglish
Pages (from-to)70-76
Number of pages7
JournalSchizophrenia Research
Volume149
Issue number1-3
DOIs
Publication statusPublished - Sept 2013

Keywords

  • First episode psychosis
  • Insight
  • Neuropsychology
  • Recovery
  • 1ST-EPISODE SCHIZOPHRENIA
  • DISORDERS
  • NEUROCOGNITION
  • SCALE
  • OUTPATIENTS
  • AWARENESS
  • SYMPTOMS
  • SUICIDE
  • ILLNESS
  • STATE
  • Acknowledged-BRC
  • Acknowledged-BRC-13/14

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