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Cognitive reserve as a moderator of outcomes in five clusters of first episode psychosis patients: a 10-year follow-up study of the PAFIP cohort

Published online by Cambridge University Press:  10 September 2021

Rosa Ayesa-Arriola Open the ORCID record for Rosa Ayesa-Arriola [Opens in a new window] ,
Victor Ortiz-García de la Foz ,
Nancy Murillo-García ,
Javier Vázquez-Bourgon ,
María Juncal-Ruiz ,
Marcos Gómez-Revuelta ,
Paula Suárez-Pinilla ,
Esther Setién-Suero  and
Benedicto Crespo-Facorro
Rosa Ayesa-Arriola*
Affiliation:
Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
Victor Ortiz-García de la Foz
Affiliation:
Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
Nancy Murillo-García
Affiliation:
Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
Javier Vázquez-Bourgon
Affiliation:
Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
María Juncal-Ruiz
Affiliation:
Department of Psychiatry, Sierrallana Hospital, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
Marcos Gómez-Revuelta
Affiliation:
Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
Paula Suárez-Pinilla
Affiliation:
Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
Esther Setién-Suero
Affiliation:
Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country, Spain
Benedicto Crespo-Facorro
Affiliation:
Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain Instituto de Investigación Sanitaria de Sevilla, IBiS, Sevilla, Spain
*
Author for correspondence: Rosa Ayesa Arriola, E-mail: rayesa@humv.es
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Abstract

Background

Cognitive reserve (CR) has been associated with the development and prognosis of psychosis. Different proxies have been used to estimate CR among individuals. A composite score of these proxies could elucidate the role of CR at illness onset on the variability of clinical and neurocognitive outcomes.

Methods

Premorbid intelligence quotient (IQ), years of education and premorbid adjustment were explored as proxies of CR in a large sample (N = 424) of first-episode psychosis (FEP) non-affective patients. Clusters of patients were identified and compared based on premorbid, clinical and neurocognitive variables at baseline. Additionally, the clusters were compared at 3-year (N = 362) and 10-year (N = 150) follow-ups.

Results

The FEP patients were grouped into five CR clusters: C1 (low premorbid IQ, low education and poor premorbid) 14%; C2 (low premorbid IQ, low education and good premorbid adjustment) 29%; C3 (normal premorbid IQ, low education and poor premorbid adjustment) 17%; C4 (normal premorbid IQ, medium education and good premorbid adjustment) 25%; and C5 (normal premorbid IQ, higher education and good premorbid adjustment) 15%. In general, positive and negative symptoms were more severe in the FEP patients with the lowest CR at baseline and follow-up assessments, while those with high CR presented and maintained higher levels of cognitive functioning.

Conclusions

CR could be considered a key factor at illness onset and a moderator of outcomes in FEP patients. A high CR could function as a protective factor against cognitive impairment and severe symptomatology. Clinical interventions focused on increasing CR and documenting long-term benefits are interesting and desirable.

Keywords

Cognitive reservefirst episode psychosislong-term outcomeneurocognition
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 5 , April 2023 , pp. 1891 - 1905
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

*

Joint first authors

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