Title:Cognition in First-Episode Psychosis: From Phenomenology to Intervention
VOLUME: 12 ISSUE: 4
Author(s):Nicholas J.K. Breitborde and Madeline Meier
Affiliation:Department of Psychiatry and Behavioral Health, The Ohio State University, 1670 Upham Dr., Columbus, Ohio
Keywords:Cognition, cognitive remediation, first-episode psychosis, treatment, cognitive enhancement, pharmacology.
Abstract:Available research has clearly demonstrated that individuals with longstanding psychotic
disorders have deficits in cognitive functioning that (i) have deleterious effects on their everyday
functioning and (ii) can be partially ameliorated via available treatment options. Despite the fact that the
cognitive deficits that accompany psychotic disorders are largely present by the time of the first-episode
of psychosis, the nature of these associations in first-episode psychosis is less clear. Data are mixed with
regard to a possible association between neurocognition and real-world functioning among individuals
with first-episode psychosis, possibly due in part to methodological limitations of available studies.
Although cognitive remediation has shown promise in ameliorating cognitive and functional deficits
among individuals with longstanding psychotic disorder, these associations are not as robust for
individuals with first-episode psychosis. With regard to pharmacological treatment, available data suggest
that antipsychotic medications do not produce meaningful gains in cognitive functioning. Data in support
of other pro-cognitive pharmacological agents are also limited. Ultimately, further research using
methodologically sound approaches is needed to clarify the role of cognitive deficits in the disability that
accompanies first-episode psychosis and to identify the most effective interventions with which to
ameliorate these cognitive deficits.
