Neurocognitive Outcomes in the Treatment of Early-Onset Schizophrenia Spectrum Disorders Study
Published Date:Mar 13 2012
Source:J Am Acad Child Adolesc Psychiatry. 2012; 51(5):496-505.
Pubmed Central ID:PMC3337647
Funding:90DD043003/DD/NCBDD CDC HHS/United States
M01-RR00037/RR/NCRR NIH HHS/United States
MCJ379154A/PHS HHS/United States
MH01-RR00046/MH/NIMH NIH HHS/United States
P30 HD004147/HD/NICHD NIH HHS/United States
R01 MH073801/MH/NIMH NIH HHS/United States
R01 MH073967/MH/NIMH NIH HHS/United States
U01 MH061355/MH/NIMH NIH HHS/United States
U01 MH061355-01A1/MH/NIMH NIH HHS/United States
U01 MH061464/MH/NIMH NIH HHS/United States
U01 MH061464-01A1/MH/NIMH NIH HHS/United States
U01 MH061528/MH/NIMH NIH HHS/United States
U01 MH061528-04/MH/NIMH NIH HHS/United States
U01 MH062726/MH/NIMH NIH HHS/United States
U01 MH062726-01/MH/NIMH NIH HHS/United States
U01MH61355/MH/NIMH NIH HHS/United States
U01MH61464/MH/NIMH NIH HHS/United States
U01MH61528/MH/NIMH NIH HHS/United States
U01MH62726/MH/NIMH NIH HHS/United States
To assess neurocognitive outcomes following antipsychotic intervention in youth enrolled in the National Institute of Mental Health (NIMH)-funded Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS).
Neurocognitive functioning of youth (ages 8–19 years) with schizophrenia or schizoaffective disorder was evaluated in a four-site randomized, double-blind clinical trial comparing molindone, olanzapine or risperidone. The primary outcomes were overall group change from baseline in neurocognitive composite and six domain scores after 8 weeks and continued treatment up to 52 weeks. Age and sex were included as covariates in all analyses.
Seventy-seven of 116 TEOSS participants (66%) had post-baseline neurocognitive data. No significant differences emerged in the neurocognitive outcomes of the three medication groups. Therefore, the three treatment groups were combined into one group to assess overall neurocognitive outcomes. Significant modest improvements were observed in the composite score and in three of six domain scores in the acute phase, and in four of six domain scores in the combined acute and maintenance phases. Partial correlation analyses revealed very few relationships among Positive and Negative Syndrome Scale (PANSS) baseline or change scores and neurocognition change scores.
Antipsychotic intervention in youth with early-onset schizophrenia spectrum disorders (EOSS) led to modest improvement in measures of neurocognitive function. The changes in cognition were largely unrelated to baseline symptoms or symptom change. Small treatment effect sizes, easily accounted for by practice effects, highlight the critical need for the development of more efficacious interventions for the enduring neurocognitive deficits seen in EOSS.
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