Poster #240 DIFFERENTIAL ASSOCIATIONS BETWEEN COGNITION AND OUTCOME IN EARLY PSYCHOSIS: A COHORT STUDY OF EARLY PSYCHOSIS PATIENTS IN THE NETHERLANDS

Abstract

Background: Substantial research done in the last few decades indicates that various neurocognition (NC) and social cognition (SC) domains are strongly associated with functional outcome in psychotic disorders. However, many studies investigating these associations have not used fully comprehensive cognitive batteries and/or a limited variety in outcome measures. Differences in demographic characteristics and methodology make integration of these findings problematic. Subsequently, our understanding of the differential associations between cognition and functional outcome remains limited, especially concerning the early stages of these disorders. This comprehensive cross-sectional study aims to investigate differential associations between cognition and outcome in a naturalistic cohort of early psychosis patients. Methods: The cognitive test-battery comprised fifteen neuropsychological measures to assess (a) general cognition, (b) seven NC domains (Attention, Problem solving, Speed of processing, Verbal fluency, Verbal learning, Visual learning and Working memory) and (c) four SC domains (Facial affect perception, Theory of Mind, Social knowledge and Social cognitive biases). The following global and specific outcome domains were assessed: (1) global functioning (GAF), (2) global clinical impression (CGI), (3) global social functioning (GSF) (4) social useful activities, including study and work (SUA) (5) personal and social relationships (PSR), (6) self-care (SeC), (7) disturbing and/or aggressive behaviour (DAB), (8) perceived chronic stress (PCS), and (9) health perception (HP). Participants included 114 patients with a first-episode psychotic disorder, of which 105 completed neuropsychological assessment (92,1%; 74 males and 31 females). Bivariate correlations between cognitive domains and functional outcome variables will be examined. Results: Of the twelve cognitive domains, three were related to global outcome: Attention to CGI (r=0.33), Speed of processing to GAF/CGI/GSF (rmean=0.27), and Facial affect perception to GAF/CGI/GSF (rmean=0.33). Seven cognitive domains were related to specific outcome domains: Attention to SUA/HP (rmean=0.26), Verbal fluency to SeC (r=0.22), Verbal learning to SUA/HP (rmean=0.25), Visual learning to HP (r=0.29), Working memory to SUA (r=0.23), Facial affect perception to SUA/PSR/DAB/HP (rmean =0.29), and Social cognitive biases to PSR/DAB/PCS/HP (rmean=0.42). Of the twelve cognitive domains, only Attention and Facial affect perception were related to both global and specific functional outcome domains. The cognitive domains Problem solving, General cognition, Theory of mind and Social knowledge were unrelated to all functional outcome domains. Discussion: Findings suggest that both NC and SC are substantially but selectively associated with various functional outcome domains. The heterogeneous cognition-outcome relationship pattern in our data illustrates that specificity is crucial in order to identify viable cognitive treatment targets in early psychosis patients. Implications for early psychosis interventions and future research are discussed.