First-episode schizophrenia (FES) spectrum disorders are associated with pronounced cognitive dysfunction across all domains. However, less is known about the course of cognitive functioning, following the first presentation of psychosis, and the relationship of cognition to clinical course during initial treatment. The present longitudinal study examined the magnitude of neurocognitive impairment, using the MATRICS Consensus Cognitive Battery, in patients experiencing their first episode of psychosis at baseline and after 12 weeks of randomized antipsychotic treatment with either aripiprazole or risperidone. At baseline, FES patients evidenced marked impairments in cognitive functioning. Notably, performance on the mazes task of planning and reasoning significantly predicted the likelihood of meeting stringent criteria for positive symptom remission during the first 12 weeks of the trial. Performance on indices of general cognitive function, working memory, and verbal learning improved over time, but these improvements were mediated by improvements in both positive and negative symptoms. We did not detect any differential effects of antipsychotic medication assignment (aripiprazole vs risperidone) on cognitive functioning. Our results suggest that a brief paper-and-pencil measure reflecting planning/reasoning abilities may index responsivity to antipsychotic medication. However, improvements in cognitive functioning over time were related to clinical symptom improvement, reflecting "pseudospecificity."

中文翻译：

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认知与首发精神分裂症频谱障碍的临床反应的关系。

首发精神分裂症（FES）频谱疾病与所有领域的明显认知功能障碍有关。但是，对于首次出现精神病后的认知功能过程以及在初始治疗期间认知与临床过程的关系知之甚少。当前的纵向研究使用MATRICS共识认知电池检查了基线时以及在使用阿立哌唑或利培酮进行随机抗精神病药物治疗12周后首次出现精神病发作的患者中神经认知损害​​的程度。在基线时，FES患者的认知功能明显受损。值得注意的是 在计划和推理的迷宫任务中的表现显着预测了在试验的前12周内满足严格的阳性症状缓解标准的可能性。随着时间的流逝，一般认知功能，工作记忆和言语学习指数的表现有所改善，但这些改善是由积极和消极症状的改善介导的。我们没有发现抗精神病药物分配（阿立哌唑和利培酮）对认知功能有任何不同的影响。我们的研究结果表明，反映计划/推理能力的简短纸笔测量可能会指数出对抗精神病药物的反应性。但是，随着时间的推移，认知功能的改善与临床症状的改善有关，反映出“伪特异性”。