Cognitive impairment varies significantly among individuals with newly diagnosed psychosis

The study was led by Simon Cervenka, Professor in psychiatry at the Department of Medical Sciences, Uppsala University, and includes a meta-analysis of all studies examining cognitive function in people who come into contact with the health care system for the first time because of psychotic symptoms - before they received anti-psychotic treatment that might otherwise affect the results. A total of 2 625 people with psychosis and 2 917 controls were included in the analyses.

The results of the study confirm that cognitive impairment is present early in the course of the disease, before drug treatment is initiated, but show for the first time that this impairment varies greatly between individuals. "Compared to controls without psychosis, the patient group had almost twice as much variation in cognitive tasks, such as paying attention, learning new things and working quickly," says first author Maria Lee, PhD student at the Department of Clinical Neuroscience, Karolinska Institutet.

"It is already known that individuals with psychotic illness suffer from cognitive impairment at the group level before or during the onset of the illness. The cognitive difficulties have also been shown to play a significant role in the disability experienced by many with psychotic illness. Many healthcare professionals working with this patient group recognise that cognitive problems can vary greatly between individuals, but this has not been systematically demonstrated before," says Maria Lee. The results clearly show the importance of individual assessment of cognition in patients with psychosis, in order to identify the people who best need help and support, and contribute to the development of precision medicine approaches in psychosis care.

The study has the Swedish Research Council as main funder.