COGNITIVE DYSFUNCTION IN FEP PATIENTS: AN IMBALANCED ASSOCIATION WITH POSITIVE AND NEGATIVE SYMPTOMS
Authors: Serretti *Alessandro , Rodríguez-Jiménez Roberto , Romero-Ferreiro Veronica , Nuñez-Doyle Aggie , Fabbri Chiara , Fanelli Giuseppe , Scala Mauro 
Published: February 2025

Abstract

Background
Cognitive impairment is observed across all stages of schizophrenia, including the high-risk state and the first-episode psychosis (FEP) (1). While higher cognitive impairment is typically associated with deficit schizophrenia (2), there is inconclusive evidence regarding the specific cognitive dysfunction associated with psychotic symptoms in FEP (1).

Aims & Objectives
The aim of the present study was to investigate the possible associations between psychotic symptoms and the cognitive abilities assessed with a standard cognitive battery, in a sample of patients with FEP who received a diagnosis of schizophrenia after six months.

Method
46 patients with FEP (25.3, SD:7.1 years old; 69% male) were included. The cognitive assessment was performed using the MATRICS Consensus Cognitive Battery (MCCB) (3). The MCCB includes ten tests that assess seven cognitive domains (speed of processing, working memory, attention/vigilance, verbal learning, visual learning, reasoning and problem solving, and social cognition). Pearson's correlations between the Positive and Negative Syndrome Scale (PANSS) (4) and the MCCB scores were assessed.

Results
The significant negative correlations between the PANSS and the MCCB scores are presented in the table.

Discussion & Conclusion
Our findings suggest negative correlations between the cognitive domains of speed of processing, working memory, verbal learning, and social cognition with negative symptoms and to a lesser extent, with general psychopathology. No significant correlations were found with positive symptoms, potentially suggesting that patients with less compromised cognitive functioning are more likely to present predominantly positive symptoms (5). These findings emphasize the need for tailored interventions to address cognitive deficits in patients FEP with predominant negative symptoms. Further research is warranted to comprehensively unravel the intricate interplay between cognitive functioning and various symptom dimensions in FEP.

References
1Plichta P, Tyburski E, Bielecki M, Mak M, Kucharska-Mazur J, Podwalski P, et al. (2023). Cognitive Dysfunctions Measured with the MCCB in Deficit and Non-Deficit Schizophrenia. J Clin Med, 12(6), 2257.
2Bora E, Binnur Akdede B, Alptekin K. (2017). Neurocognitive impairment in deficit and non-deficit schizophrenia: a meta-analysis. Psychol Med, 47(14), 2401–13.
3Kern RS, Nuechterlein KH, Green MF, Baade LE, Fenton WS, Gold JM, et al. (2008). The MATRICS Consensus Cognitive Battery, Part 2: Co-Norming and Standardization. Am J Psychiatry, 165(2), 214–20.
4.Kay SR, Fiszbein A, Opler LA. (1987). The Positive and Negative Syndrome Scale (PANSS) for Schizophrenia. Schizophr Bull, 13(2), 261–76.
5.Amoretti S, Rabelo-da-Ponte FD, Rosa AR, Mezquida G, Sá nchez-Torres AM, Fraguas D, et al. (2021). Cognitive clusters in first-episode psychosis. Schizophr Res, 237, 31–9.