Cognitive dysfunction in acute psychosis

Abstract

Introduction

Patients with psychosis often present with cognitive dysfunction during the course of their illness. Inflammatory markers such as cytokines and neurotrophins have been investigated, as they are relevant to the change in cognitive function.

Objectives

To evaluate the cognitive function between patients with acute psychosis and those without. Moreover, this study also investigates cytokines and neurotrophins levels in acute psychosis and their relation with cognition, severity of psychosis and trajectory of their levels across time and under treatment.

Methods

Longitudinal, observational, pilot study, of psychiatric inpatients. Participants were assessed on the first day using brief psychiatric rating scale, CAGE, trail making test B and Wisconsin card sorting test. These assessments were repeated weekly until patients were discharged. Blood samples were also collected on the same day for cytokines and neurotrophins analysis. However, the result on cytokines and neurotrophins levels is still pending, therefore only clinical findings will be presented.

Results

Thirty-one patients (mean age: 43.7, SD: 18.9, 14 females and 17 males) were recruited. Eleven were acutely psychotic. Generalized estimating equations modelling were used to compare these two groups based on cognitive and demographic variables. Patients with psychosis are more likely to have significantly lower scores for CAGE (Wald-x2 = 6.268, df = 1, P = 0.012), significantly more abnormal scores in Trail Making Test B (Wald–x2 = 7.338, df = 1, P = 0.007), failure to maintain set (Wald–x2 = 8.323, df = 1, P = 0.004) and perseveratives errors (Wald-x2 = 4.385, df = 1, P = 0.036) although they have more years of education than those without psychosis.

Conclusions

These data show individuals with acute psychosis have impaired cognitive function compared to others.

Disclosure of interest

The authors have not supplied their declaration of competing interest.