Letícia Sanguinetti Czepielewski1,2, Luz Maria Alliende3,4, Carmen Paz Castañeda4, Mariana Castro5,6, Salvador M Guinjoan7, Raffael Massuda8, Arthur A Berberian9, Ana Olivia Fonseca9, Ary Gadelha10, Rodrigo Bressan9, Marisa Crivelaro11, Mario Louzã11, Juan Undurraga4,12, Alfonso González-Valderrama4,13, Rubén Nachar4,13, Rodrigo R Nieto14,15,16, Cristian Montes14,15, Hernan Silva14,15, Álvaro I Langer17,18,19,20, Carlos Schmidt20,21, Rocío Mayol-Troncoso14,15,19, Ana M Díaz-Zuluaga22, Johanna Valencia-Echeverry22, Carlos López-Jaramillo22, Rodolfo Solís-Vivanco23, Francisco Reyes-Madrigal24, Camilo de la Fuente-Sandoval24,25, Nicolás A Crossley3,26,27, Clarissa S Gama1,28. 1. Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. 2. Programa de Pós-Graduação em Psicologia, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. 3. Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. 4. Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile. 5. Research Group on Neurosciences as applied to Abnormal Behaviour (INAAC Group), FLENI-CONICET Neurosciences Institute, Buenos Aires, Argentina. 6. Department of Psychiatry and Mental Health (Fleni Teaching Unit) and Department of Physiology, University of Buenos Aires School of Medicine, Buenos Aires, Argentina. 7. Department of Psychiatry and Mental Health (Fleni Teaching Unit), University of Buenos Aires School of Medicine. CONICET, Buenos Aires, Argentina. 8. Departamento de Psiquiatria, Universidade Federal do Paraná (UFPR), Curitiba, Brazil. 9. Universidade Federal de São Paulo, São Paulo, Brazil. 10. Programa de Esquizofrenia, da Escola Paulista de Medicina Universidade Federal de São Paulo (PROESQ-EPM/UNIFESP). Laboratory of Integrative Neuroscience (LINC), Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil. 11. PROJESQ (Programa de Esquizofrenia), Instituto de Psiquiatria do HCFMUSP, São Paulo, Brazil. 12. Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. 13. School of Medicine, Universidad Finis Terrae, Santiago, Chile. 14. University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile. 15. Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile. 16. Department of Neuroscience, Faculty of Medicine, Universidad de Chile, Santiago, Chile. 17. Instituto de Estudios Psicológicos, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile. 18. Center for Interdisciplinary Studies on the Nervous System (CISNe), Universidad Austral de Chile, Valdivia, Chile. 19. Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay),Santiago, Chile. 20. Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile. 21. Brain, Cognition and Behavior PhD Program, University of Barcelona, Barcelona, Spain. 22. Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia. 23. Laboratory of Neuropsychology, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico. 24. Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico. 25. Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico. 26. Biomedical Imaging Center and Center for Integrative Neuroscience, Pontificia Universidad Católica de Chile, Santiago, Chile. 27. Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK. 28. Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Abstract
BACKGROUND: Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls. METHODS: We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments. RESULTS: Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology. CONCLUSIONS: Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.
BACKGROUND: Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls. METHODS: We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments. RESULTS:Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology. CONCLUSIONS:Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.
Entities:
Keywords:
Cognition; low- and middle-income countries; schizophrenia; social factors