TY - JOUR
T1 - Cross-sectional study comparing cognitive function in treatment responsive versus treatment non-responsive schizophrenia
T2 - Evidence from the STRATA study
AU - Millgate, Edward
AU - Kravariti, Eugenia
AU - Egerton, Alice
AU - Howes, Oliver D.
AU - Murray, Robin M.
AU - Kassoumeri, Laura
AU - Donocik, Jacek
AU - Lewis, Shôn
AU - Drake, Richard
AU - Lawrie, Stephen
AU - Murphy, Anna
AU - Collier, Tracy
AU - Lees, Jane
AU - Stockton-Powdrell, Charlotte
AU - Walters, James
AU - Deakin, Bill
AU - MacCabe, James
N1 - Funding Information:
Funding STRATA is funded by a grant from the Medical Research Council (MRC) to JM, grant reference MR/L011794. EM’s PhD is funded by the MRC-doctoral training partnership studentship in Biomedical Sciences at King’s College London. JM, EK, RMM, AE and ODH are part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. In the past three years, SLe has received personal support from Sunovion.
Publisher Copyright:
© 2021 BMJ Publishing Group. All rights reserved.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Background 70%–84% of individuals with antipsychotic treatment resistance show non-response from the first episode. Emerging cross-sectional evidence comparing cognitive profiles in treatment resistant schizophrenia to treatment-responsive schizophrenia has indicated that verbal memory and language functions may be more impaired in treatment resistance. We sought to confirm this finding by comparing cognitive performance between antipsychotic non-responders (NR) and responders (R) using a brief cognitive battery for schizophrenia, with a primary focus on verbal tasks compared against other measures of cognition. Design Cross-sectional. Setting This cross-sectional study recruited antipsychotic treatment R and antipsychotic NR across four UK sites. Cognitive performance was assessed using the Brief Assessment of Cognition in Schizophrenia (BACS). Participants One hundred and six participants aged 18–65 years with a diagnosis of schizophrenia or schizophreniform disorder were recruited according to their treatment response, with 52 NR and 54 R cases. Outcomes Composite and subscale scores of cognitive performance on the BACS. Group (R vs NR) differences in cognitive scores were investigated using univariable and multivariable linear regressions adjusted for age, gender and illness duration. Results Univariable regression models observed no significant differences between R and NR groups on any measure of the BACS, including verbal memory (ß=−1.99, 95% CI −6.63 to 2.66, p=0.398) and verbal fluency (ß=1.23, 95% CI −2.46 to 4.91, p=0.510). This pattern of findings was consistent in multivariable models. Conclusions The lack of group difference in cognition in our sample is likely due to a lack of clinical distinction between our groups. Future investigations should aim to use machine learning methods using longitudinal first episode samples to identify responder subtypes within schizophrenia, and how cognitive factors may interact within this.
AB - Background 70%–84% of individuals with antipsychotic treatment resistance show non-response from the first episode. Emerging cross-sectional evidence comparing cognitive profiles in treatment resistant schizophrenia to treatment-responsive schizophrenia has indicated that verbal memory and language functions may be more impaired in treatment resistance. We sought to confirm this finding by comparing cognitive performance between antipsychotic non-responders (NR) and responders (R) using a brief cognitive battery for schizophrenia, with a primary focus on verbal tasks compared against other measures of cognition. Design Cross-sectional. Setting This cross-sectional study recruited antipsychotic treatment R and antipsychotic NR across four UK sites. Cognitive performance was assessed using the Brief Assessment of Cognition in Schizophrenia (BACS). Participants One hundred and six participants aged 18–65 years with a diagnosis of schizophrenia or schizophreniform disorder were recruited according to their treatment response, with 52 NR and 54 R cases. Outcomes Composite and subscale scores of cognitive performance on the BACS. Group (R vs NR) differences in cognitive scores were investigated using univariable and multivariable linear regressions adjusted for age, gender and illness duration. Results Univariable regression models observed no significant differences between R and NR groups on any measure of the BACS, including verbal memory (ß=−1.99, 95% CI −6.63 to 2.66, p=0.398) and verbal fluency (ß=1.23, 95% CI −2.46 to 4.91, p=0.510). This pattern of findings was consistent in multivariable models. Conclusions The lack of group difference in cognition in our sample is likely due to a lack of clinical distinction between our groups. Future investigations should aim to use machine learning methods using longitudinal first episode samples to identify responder subtypes within schizophrenia, and how cognitive factors may interact within this.
KW - Antipsychotic Agents
KW - Cognition
KW - Cognition Disorders
KW - Cross-Sectional Studies
KW - Neuropsychological Tests
KW - Schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=85121234647&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-054160
DO - 10.1136/bmjopen-2021-054160
M3 - Article
C2 - 34824121
AN - SCOPUS:85121234647
VL - 11
JO - BMJ Open
JF - BMJ Open
SN - 2044-6055
IS - 11
M1 - e054160
ER -