Mental disorders and their functional impacts evolve dynamically over time. Neurocognition and clinical symptoms are commonly modelled as predictors of functioning, however, studies tend to rely on static variables and adult samples with chronic disorders, with limited research investigating change in these variables in young people with emerging mental disorders. These relationships were explored in a longitudinal clinical cohort of young people accessing early intervention mental health services in Australia, around three-quarters of whom presented with a mood disorder (N = 176, aged 12–30 at baseline). Bivariate latent change score models quantified associations between neurocognition (a latent variable of working memory, verbal memory, visuospatial memory, and cognitive flexibility), global clinical symptoms, and functioning (self- and clinician-rated) and their relative change over follow-up (median = 20 months). We found that longitudinal changes in functioning were coupled with changes in global clinical symptoms (β = −0.43, P < 0.001), such that improvement in functioning was related to improvement in clinical symptoms. Changes in neurocognition were not significantly associated with changes in functioning or clinical symptoms. Main findings were upheld in three sensitivity analyses restricting the sample to: (a) adults aged 18–30; (b) participants with 12–24 months of follow-up; and (c) participants without a psychotic disorder. Our findings show that global symptom reduction and functional improvement are related in young people with emerging mental disorders. More work is needed to determine the temporal precedence of change in these variables. Future studies should apply this methodology to intervention studies to untangle the causal dynamics between neurocognition, symptoms, and functioning.

精神障碍及其功能影响会随着时间动态变化。神经认知和临床症状通常被建模为功能的预测指标，但是，研究倾向于依赖静态变量和患有慢性疾病的成人样本，而针对新兴精神障碍的年轻人中这些变量变化的研究却很少。在澳大利亚的纵向临床队列中探讨了这些关系，这些年轻人在澳大利亚获得了早期干预的心理健康服务，其中大约四分之三的人患有情绪障碍（N = 176，基线时为12-30岁）。双变量潜在变化评分模型可量化神经认知（工作记忆，言语记忆，视觉空间记忆和认知灵活性的潜在变量），整体临床症状之间的关联，和功能（自我和临床医生评估）及其在随访中的相对变化（中位数= 20个月）。我们发现，功能的纵向变化与整体临床症状的变化相关（β= -0.43，P <0.001），因此功能的改善与临床症状的改善有关。神经认知的改变与功能或临床症状的改变没有显着相关。在三项敏感性分析中坚持了主要发现，将样本限制为：（a）18至30岁的成年人；（b）参与者有12-24个月的随访；（c）没有精神病的参与者。我们的发现表明，新出现的精神障碍患者的总体症状减轻和功能改善与他们有关。确定这些变量的时间优先顺序还需要做更多的工作。未来的研究应将此方法应用于干预研究，以理清神经认知，症状和功能之间的因果关系。