Abstract
Inverse relationships between the C-reactive protein (CRP) levels and cognitive performance in acute psychosis have been demonstrated. We aimed to investigate how the serum level and initial change of CRP in acutely admitted patients with psychosis was correlated with cognitive performance during a 6-months follow-up period. The study is part of a pragmatic, randomised trial comparing four different second-generation antipsychotic drugs, and consists of 208 acute phase patients recruited at admittance for psychosis. This study reports data for all groups collectively, and does not compare treatment groups. Measurements of CRP and cognitive performance were conducted at baseline (T1) and after 4 weeks on average after inclusion (T2). Cognition was also assessed after 3 months (T3) and 6 months (T4) of follow-up. Global cognition improved during the follow-up period of 6 months, especially in the T1-T2 interval. The different cognitive subdomains showed different time-dependent profiles of improvement, with memory and attention improving significantly also in the later phases. Reduction of the CRP level during the initial follow-up interval (T1-T2) was associated with increased overall cognitive performance in the T2-T4 interval, but not in the T1-T2 interval. For the cognitive subdomains, we found an inverse association between change in CRP level and verbal abilities (T2-T4 interval), and attention (T2-T3 interval). These findings indicate that initial changes in the serum level of CRP in the acute phase of psychosis may predict cognitive function in later phases of the disease.
Highlights
Cognitive dysfunctions are core features of schizophrenia that detrimentally affect functional outcome [1,2,3]
We have recently shown an inverse association between the serum level of C-reactive protein (CRP) and cognitive performance in the acute phase of psychosis [11]
The patients that were tested only at baseline were not statistically different from those with follow-up data for the clinical or demographic characteristics at baseline, with the exception of a higher Positive and Negative Syndrome Scale (PANSS) negative subscale score in patients with baseline test only compared to those with two or more visits [independent samples t-test: p = 0.034; mean difference 2.2 points; 95% confidence interval (CI): 0.2–4.2], and fewer years of education
Summary
Cognitive dysfunctions are core features of schizophrenia that detrimentally affect functional outcome [1,2,3]. Recent findings indicate that cognitive dysfunction is not always irreversible and can be dynamic, especially in the acute phases [11,12]. Current treatment options in psychosis, including psychosocial interventions and antipsychotic medications, have few if any beneficial effects on cognitive performance [4,13,14,15,16,17]. This central area of dysfunction in psychosis is in need of a better understanding and novel treatment approaches
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