Longitudinal clinical and functional outcome in distinct cognitive subgroups of first-episode psychosis : A cluster analysis
(2023) In Psychological Medicine 53(6). p.2317-2327- Abstract
Background Cognitive deficits may be characteristic for only a subgroup of first-episode psychosis (FEP) and the link with clinical and functional outcomes is less profound than previously thought. This study aimed to identify cognitive subgroups in a large sample of FEP using a clustering approach with healthy controls as a reference group, subsequently linking cognitive subgroups to clinical and functional outcomes. Methods 204 FEP patients were included. Hierarchical cluster analysis was performed using baseline brief assessment of cognition in schizophrenia (BACS). Cognitive subgroups were compared to 40 controls and linked to longitudinal clinical and functional outcomes (PANSS, GAF, self-reported WHODAS 2.0) up to 12-month... (More)
Background Cognitive deficits may be characteristic for only a subgroup of first-episode psychosis (FEP) and the link with clinical and functional outcomes is less profound than previously thought. This study aimed to identify cognitive subgroups in a large sample of FEP using a clustering approach with healthy controls as a reference group, subsequently linking cognitive subgroups to clinical and functional outcomes. Methods 204 FEP patients were included. Hierarchical cluster analysis was performed using baseline brief assessment of cognition in schizophrenia (BACS). Cognitive subgroups were compared to 40 controls and linked to longitudinal clinical and functional outcomes (PANSS, GAF, self-reported WHODAS 2.0) up to 12-month follow-up. Results Three distinct cognitive clusters emerged: relative to controls, we found one cluster with preserved cognition (n = 76), one moderately impaired cluster (n = 74) and one severely impaired cluster (n = 54). Patients with severely impaired cognition had more severe clinical symptoms at baseline, 6- and 12-month follow-up as compared to patients with preserved cognition. General functioning (GAF) in the severely impaired cluster was significantly lower than in those with preserved cognition at baseline and showed trend-level effects at 6- and 12-month follow-up. No significant differences in self-reported functional outcome (WHODAS 2.0) were present. Conclusions Current results demonstrate the existence of three distinct cognitive subgroups, corresponding with clinical outcome at baseline, 6- and 12-month follow-up. Importantly, the cognitively preserved subgroup was larger than the severely impaired group. Early identification of discrete cognitive profiles can offer valuable information about the clinical outcome but may not be relevant in predicting self-reported functional outcomes.
(Less)
- author
- publishing date
- 2023-04-19
- type
- Contribution to journal
- publication status
- published
- keywords
- Clustering, cognition, FEP, functional outcome, global functioning, psychosis
- in
- Psychological Medicine
- volume
- 53
- issue
- 6
- pages
- 2317 - 2327
- publisher
- Cambridge University Press
- external identifiers
-
- pmid:34664546
- scopus:85124477366
- ISSN
- 0033-2917
- DOI
- 10.1017/S0033291721004153
- language
- English
- LU publication?
- no
- additional info
- Publisher Copyright: Copyright © The Author(s), 2021. Published by Cambridge University Press.
- id
- fb7c0296-bd98-46be-84be-655adc06eacf
- date added to LUP
- 2024-10-21 10:49:04
- date last changed
- 2025-07-15 09:37:52
@article{fb7c0296-bd98-46be-84be-655adc06eacf,
abstract = {{<p>Background Cognitive deficits may be characteristic for only a subgroup of first-episode psychosis (FEP) and the link with clinical and functional outcomes is less profound than previously thought. This study aimed to identify cognitive subgroups in a large sample of FEP using a clustering approach with healthy controls as a reference group, subsequently linking cognitive subgroups to clinical and functional outcomes. Methods 204 FEP patients were included. Hierarchical cluster analysis was performed using baseline brief assessment of cognition in schizophrenia (BACS). Cognitive subgroups were compared to 40 controls and linked to longitudinal clinical and functional outcomes (PANSS, GAF, self-reported WHODAS 2.0) up to 12-month follow-up. Results Three distinct cognitive clusters emerged: relative to controls, we found one cluster with preserved cognition (n = 76), one moderately impaired cluster (n = 74) and one severely impaired cluster (n = 54). Patients with severely impaired cognition had more severe clinical symptoms at baseline, 6- and 12-month follow-up as compared to patients with preserved cognition. General functioning (GAF) in the severely impaired cluster was significantly lower than in those with preserved cognition at baseline and showed trend-level effects at 6- and 12-month follow-up. No significant differences in self-reported functional outcome (WHODAS 2.0) were present. Conclusions Current results demonstrate the existence of three distinct cognitive subgroups, corresponding with clinical outcome at baseline, 6- and 12-month follow-up. Importantly, the cognitively preserved subgroup was larger than the severely impaired group. Early identification of discrete cognitive profiles can offer valuable information about the clinical outcome but may not be relevant in predicting self-reported functional outcomes.</p>}},
author = {{Oomen, Priscilla P. and Begemann, Marieke J.H. and Brand, Bodyl A. and De Haan, Lieuwe and Veling, Wim and Koops, Sanne and Van Os, Jim and Smit, Filip and Bakker, P. Roberto and Van Beveren, Nico and Boonstra, Nynke and Gülöksüz, Sinan and Kikkert, Martijn and Lokkerbol, Joran and Marcelis, Machteld and Rosema, Bram Sieben and De Beer, Franciska and Gangadin, Shiral S. and Geraets, Chris N.W. and Van'T Hag, Erna and Haveman, Yudith and Van Der Heijden, Inge and Voppel, Alban E. and Willemse, Elske and Van Amelsvoort, Therese and Bak, Maarten and Batalla, Albert and Been, Agaath and Van Den Bosch, Marinte and Van Den Brink, Truus and Faber, Gunnar and Grootens, Koen P. and De Jonge, Martin and Knegtering, Rikus and Kurkamp, Jörg and Mahabir, Amrita and Pijnenborg, Gerdina H.M. and Staring, Tonnie and Veen, Natalie and Veerman, Selene and Wiersma, Sybren and Graveland, Ellen and Hoornaar, Joelle and Sommer, Iris E.C.}},
issn = {{0033-2917}},
keywords = {{Clustering; cognition; FEP; functional outcome; global functioning; psychosis}},
language = {{eng}},
month = {{04}},
number = {{6}},
pages = {{2317--2327}},
publisher = {{Cambridge University Press}},
series = {{Psychological Medicine}},
title = {{Longitudinal clinical and functional outcome in distinct cognitive subgroups of first-episode psychosis : A cluster analysis}},
url = {{http://dx.doi.org/10.1017/S0033291721004153}},
doi = {{10.1017/S0033291721004153}},
volume = {{53}},
year = {{2023}},
}