T Wobrock1, P Falkai2, T Schneider-Axmann2, A Hasan2, S Galderisi3, M Davidson4, R S Kahn5, E M Derks5, H Boter6, J K Rybakowski7, J Libiger8, S Dollfus9, J J López-Ibor10, J Peuskens11, L G Hranov12, W Gaebel13, W W Fleischhacker14. 1. Department of Psychiatry and Psychotherapy, University Medical Centre, Georg-August-University, Göttingen, Germany; Centre of Mental Health, Darmstadt-Dieburg Clinics, Groß-Umstadt, Germany. Electronic address: t.wobrock@kreiskliniken-dadi.de. 2. Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany. 3. Department of Psychiatry, University of Naples SUN, Naples, Italy. 4. Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Israel. 5. Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, The Netherlands. 6. Department of Epidemiology (unit HTA), University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands. 7. Poznan University of Medical Sciences, Poznan, Poland. 8. Department of Psychiatry, University Hospital Hradec Kralove, Czech Republic. 9. Department of Adult Psychiatry, Centre Hospitalier Universitaire, Centre Esquirol, Caen, France. 10. Institute of Psychiatry and Mental Health, San Carlos Clinical University Hospital of Madrid, Spain. 11. University Psychiatric Centre, Katholieke Universiteit Leuven, Campus St. Jozef Kortenberg, Leuven, Belgium. 12. Department of Psychiatry, University Hospital of Neurology and Psychiatry, St. Naum, Sofia, Bulgaria. 13. Department of Psychiatry and Psychotherapy, Heinrich-Heine-University, Düsseldorf, Germany. 14. Department of Psychiatry, Department of Biological Psychiatry, Medical University of Innsbruck, Austria.
Abstract
UNLABELLED: Studies and meta-analyses investigating the influence of substance use disorder (SUD) (substance abuse or dependence) on psychopathology and neurocognitive function in schizophrenia patients have revealed controversial results. Most studies did only have small samples and did not focus exclusively on first-episode schizophrenia patients. METHOD: In a post-hoc analysis of the European First Episode Schizophrenia Trial (EUFEST) psychopathology and cognitive performances of patients with (FE-SUD, N=119, consisting of N=88 patients with persisting SUD at baseline and N=31 patients with previous SUD) and without SUD (FE-non-SUD, N=204) were compared at baseline and 6 months follow-up. Neurocognitive assessment included the Rey Auditory Verbal Learning Test (RAVLT); Trail Making Tests A and B (TMT), Purdue Pegboard and Digit-Symbol Coding. RESULTS: In total 31.1% of patients reported SUD, and 22.2% of patients used cannabis. There were no significant differences between patients with and without SUD concerning PANSS scores, extrapyramidal motor symptoms or neurocognitive measures except better performance in psychomotor speed (TMT-A, p=0.033, Cohen's d=0.26) in patients with SUD at 6 months follow-up. Interestingly, SUD patients with ongoing substance use at follow-up showed elevated positive symptoms (PANSS positive score, p=0.008, Cohen's d=0.84) compared to those who abstained. PANSS scores at baseline were increased in patients with an onset of SUD before the age of 16 years. In addition we found a correlation between longer duration of cannabis use and higher cognitive performance as well as reduced symptom improvement and more extrapyramidal motor symptoms in patients with higher frequency of cannabis consumption. CONCLUSIONS:FE-SUD and FE-non-SUD show similar psychopathology and neuropsychological performances at baseline and during the first 6 months of antipsychotic treatment.
RCT Entities:
UNLABELLED: Studies and meta-analyses investigating the influence of substance use disorder (SUD) (substance abuse or dependence) on psychopathology and neurocognitive function in schizophreniapatients have revealed controversial results. Most studies did only have small samples and did not focus exclusively on first-episode schizophreniapatients. METHOD: In a post-hoc analysis of the European First Episode Schizophrenia Trial (EUFEST) psychopathology and cognitive performances of patients with (FE-SUD, N=119, consisting of N=88 patients with persisting SUD at baseline and N=31 patients with previous SUD) and without SUD (FE-non-SUD, N=204) were compared at baseline and 6 months follow-up. Neurocognitive assessment included the Rey Auditory Verbal Learning Test (RAVLT); Trail Making Tests A and B (TMT), Purdue Pegboard and Digit-Symbol Coding. RESULTS: In total 31.1% of patients reported SUD, and 22.2% of patients used cannabis. There were no significant differences between patients with and without SUD concerning PANSS scores, extrapyramidal motor symptoms or neurocognitive measures except better performance in psychomotor speed (TMT-A, p=0.033, Cohen's d=0.26) in patients with SUD at 6 months follow-up. Interestingly, SUD patients with ongoing substance use at follow-up showed elevated positive symptoms (PANSS positive score, p=0.008, Cohen's d=0.84) compared to those who abstained. PANSS scores at baseline were increased in patients with an onset of SUD before the age of 16 years. In addition we found a correlation between longer duration of cannabis use and higher cognitive performance as well as reduced symptom improvement and more extrapyramidal motor symptoms in patients with higher frequency of cannabis consumption. CONCLUSIONS:FE-SUD and FE-non-SUD show similar psychopathology and neuropsychological performances at baseline and during the first 6 months of antipsychotic treatment.
Authors: Bernard A Fischer; Robert P McMahon; Deanna L Kelly; Heidi J Wehring; Walter A Meyer; Stephanie Feldman; William T Carpenter; David A Gorelick Journal: Schizophr Res Date: 2014-11-22 Impact factor: 4.939
Authors: Shaun M Eack; Susan S Hogarty; Deborah P Greenwald; Maralee Y Litschge; Summer A F McKnight; Srihari S Bangalore; Michael F Pogue-Geile; Matcheri S Keshavan; Jack R Cornelius Journal: Schizophr Res Date: 2014-12-12 Impact factor: 4.939
Authors: Berend Malchow; Alkomiet Hasan; Thomas Schneider-Axmann; Alexander Jatzko; Oliver Gruber; Andrea Schmitt; Peter Falkai; Thomas Wobrock Journal: Eur Arch Psychiatry Clin Neurosci Date: 2013-10-02 Impact factor: 5.270