The British Journal of Psychiatry

Journal Information
ISSN / EISSN : 0007-1250 / 1472-1465
Published by: Royal College of Psychiatrists (10.1192)
Total articles ≅ 31,027
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Latest articles in this journal

Leif Norgaard Gregersen
Published: 26 September 2022
The British Journal of Psychiatry, Volume 221, pp 643-643; https://doi.org/10.1192/bjp.2022.57

, Dan W. Joyce, Dawn N. Albertson, Sukhwinder S. Shergill
Published: 26 September 2022
The British Journal of Psychiatry, Volume 221, pp 651-652; https://doi.org/10.1192/bjp.2022.127

Katie Thornton, Thomas McCabe
Published: 26 September 2022
The British Journal of Psychiatry, Volume 221, pp 646-646; https://doi.org/10.1192/bjp.2022.88

, Lauren Harrison, Antonio Preti, ,
Published: 23 September 2022
The British Journal of Psychiatry pp 1-8; https://doi.org/10.1192/bjp.2022.131

Abstract:
Background: Cognitive impairment is a core feature of schizophrenia, associated with poor functional outcomes. The course of cognitive function in the years following illness onset has remained a subject of debate, with a previous analysis finding no worsening, providing support for the neurodevelopmental model of schizophrenia. Since then, many more studies have reported on longitudinal cognitive performance in early psychosis, with some indicating deterioration, which does not align with this view. Aims: This study aims to quantitatively review the literature on the longitudinal trajectory of cognitive deficits in the years following psychosis onset, in comparison with healthy controls. It is the first to also synthesise longitudinal data on social cognition. Method: Electronic databases (‘PubMed’, ‘PsycInfo’ and ‘Scopus’) were searched (to end September 2021). Meta-analyses of 25 longitudinal studies of cognition in early psychosis were conducted (1480 patients, 789 health controls). Unlike previous analyses, randomised controlled trials and those with multiple cognitive testing periods within the first year were excluded to minimise bias (PROSPERO, ID: CRD42021241525). Results: Small improvements were observed for global cognition (g = 0.25, 95% CI 0.17–0.33) and individual cognitive domains, but these were comparable with healthy controls and likely an artefact of practice effects. Conclusions: There is no evidence of continued cognitive decline or improvement in the early years following psychosis onset, with a need for more studies over longer follow-up periods. Practice effects highlight the importance of including control samples in longitudinal and intervention studies. Further data are needed to evaluate the course of social cognition subdomains.
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