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Modelling associations between neurocognition and functional course in young people with emerging mental disorders: a longitudinal cohort study

Lookup NU author(s): Emeritus Professor Jan Scott

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Abstract

© 2020, The Author(s).Neurocognitive impairment is commonly associated with functional disability in established depressive, bipolar and psychotic disorders. However, little is known about the longer-term functional implications of these impairments in early phase transdiagnostic cohorts. We aimed to examine associations between neurocognition and functioning at baseline and over time. We used mixed effects models to investigate associations between neurocognitive test scores and longitudinal social and occupational functioning (“Social and Occupational Functioning Assessment Scale”) at 1–7 timepoints over five-years in 767 individuals accessing youth mental health services. Analyses were adjusted for age, sex, premorbid IQ, and symptom severity. Lower baseline functioning was associated with male sex (coefficient −3.78, 95% CI −5.22 to −2.34 p < 0.001), poorer verbal memory (coefficient 0.90, 95% CI 0.42 to 1.38, p < 0.001), more severe depressive (coefficient −0.28, 95% CI −0.41 to −0.15, p < 0.001), negative (coefficient −0.49, 95% CI −0.74 to −0.25, p < 0.001), and positive symptoms (coefficient −0.25, 95% CI −0.41 to −0.09, p = 0.002) and lower premorbid IQ (coefficient 0.13, 95% CI 0.07 to 0.19, p < 0.001). The rate of change in functioning over time varied among patients depending on their sex (male; coefficient 0.73, 95% CI 0.49 to 0.98, p < 0.001) and baseline level of cognitive flexibility (coefficient 0.14, 95% CI 0.06 to 0.22, p < 0.001), such that patients with the lowest scores had the least improvement in functioning. Impaired cognitive flexibility is common and may represent a meaningful and transdiagnostic target for cognitive remediation in youth mental health settings. Future studies should pilot cognitive remediation targeting cognitive flexibility while monitoring changes in functioning.

Publication metadata

Author(s): Crouse JJ, Chitty KM, Iorfino F, Carpenter JS, White D, Nichles A, Zmicerevska N, Guastella AJ, Scott EM, Lee RSC, Naismith SL, Scott J, Hermens DF, Hickie IB

Publication type: Article

Publication status: Published

Journal: Translational Psychiatry

Year: 2020

Volume: 10

Issue: 1

Online publication date: 21/01/2020

Acceptance date: 10/01/2020

ISSN (electronic): 2158-3188

Publisher: Springer Nature

URL: https://doi.org/10.1038/s41398-020-0726-9

DOI: 10.1038/s41398-020-0726-9

PubMed id: 32066687

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