The longitudinal effect of antipsychotic burden on psychosocial functioning in first-episode psychosis patients: the role of verbal memory
Por:
Ballesteros, A, Torres, AMS, Lopez-Ilundain, J, Mezquida, G, Lobo, A, Gonzalez-Pinto, A, Pina-Camacho, L, Corripio, I, Vieta, E, de la Serna, E, Mane, A, Bioque, M, Moreno-Izco, L, Espliego, A, Lorente-Omenaca, R, Amoretti, S, Bernardo, M, Cuesta, MJ
Publicada:
1 sep 2021
Resumen:
Background Previous literature supports antipsychotics' (AP) efficacy in acute first-episode psychosis (FEP) in terms of symptomatology and functioning but also a cognitive detrimental effect. However, regarding functional recovery in stabilised patients, these effects are not clear. Therefore, the main aim of this study is to investigate dopaminergic/anticholinergic burden of (AP) on psychosocial functioning in FEP. We also examined whether cognitive impairment may mediate these effects on functioning. Methods A total of 157 FEP participants were assessed at study entry, and at 2 months and 2 years after remission of the acute episode. The primary outcomes were social functioning as measured by the functioning assessment short test (FAST). Cognitive domains were assessed as potential mediators. Dopaminergic and anticholinergic AP burden on 2-year psychosocial functioning [measured with chlorpromazine (CPZ) and drug burden index] were independent variables. Secondary outcomes were clinical and socio-demographic variables. Results Mediation analysis found a statistical but not meaningful contribution of dopaminergic receptor blockade burden to worse functioning mediated by cognition (for every 600 CPZ equivalent points, 2-year FAST score increased 1.38 points). Regarding verbal memory and attention, there was an indirect effect of CPZ burden on FAST (b = 0.0045, 95% CI 0.0011-0.0091) and (b = 0.0026, 95% CI 0.0001-0.0006) respectively. However, only verbal memory post hoc analyses showed a significant indirect effect (b = 0.009, 95% CI 0.033-0.0151) adding premorbid IQ as covariate. We did not find significant results for anticholinergic burden. Conclusion CPZ dose effect over functioning is mediated by verbal memory but this association appears barely relevant.
Filiaciones:
Ballesteros, A:
Red Salud Mental Navarra, Serv Navarro Salud Osasunbidea, Pamplona, Spain
Inst Invest Sanit Navarra IdiSNa, Pamplona, Spain
Torres, AMS:
Complejo Hosp Navarra, Dept Psychiat, Pamplona, Spain
Inst Invest Sanit Navarra IdiSNa, Pamplona, Spain
Lopez-Ilundain, J:
Complejo Hosp Navarra, Dept Psychiat, Pamplona, Spain
Inst Invest Sanit Navarra IdiSNa, Pamplona, Spain
Mezquida, G:
Univ Barcelona, Hosp Clin Barcelona,Barcelona Clin Schizophrenia, August Pi & Sunyer Biomed Res Inst IDIBAPS, Neurosci Inst,Ctr Invest Biomed Red Salud Mental, Barcelona, Spain
Lobo, A:
Zaragoza Univ, Inst Invest Sanit Aragon IIS Aragon, Dept Med & Psychiat, Zaragoza, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Gonzalez-Pinto, A:
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Univ Basque Country, Univ Hosp, BIOARABA Hlth Res Inst, OSI Araba, Vitoria, Spain
Pina-Camacho, L:
Univ Complutense, Univ Gregorio Maranon, Hosp Gen,CIBERSAM, Sch Med,Child & Adolescent Psychiat Dept,IISGM, Madrid, Spain
Corripio, I:
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Univ Autonoma Barcelona UAB, Hosp Santa Creu & St Pau, Inst dInvest Biomed St Pau IIB ST PAU, Psychiat Dept, Barcelona, Spain
Vieta, E:
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Univ Barcelona, Hosp Clin, IDIBAPS, Unidad Trastornos Bipolares & Depresivos, Barcelona, Spain
de la Serna, E:
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Hosp Clin Barcelona, Clin Inst Neurosci, Dept Child & Adolescent Psychiat & Psychol, 2017SGR881, Barcelona, Spain
Mane, A:
Autonomous Univ Barcelona, Hosp Mar Med Res Inst IMIM, CIBERSAM, Barcelona, Spain
Bioque, M:
Univ Barcelona, Hosp Clin Barcelona,Barcelona Clin Schizophrenia, August Pi & Sunyer Biomed Res Inst IDIBAPS, Neurosci Inst,Ctr Invest Biomed Red Salud Mental, Barcelona, Spain
Moreno-Izco, L:
Complejo Hosp Navarra, Dept Psychiat, Pamplona, Spain
Inst Invest Sanit Navarra IdiSNa, Pamplona, Spain
Espliego, A:
Univ Complutense, Univ Gregorio Maranon, Hosp Gen,CIBERSAM, Sch Med,Child & Adolescent Psychiat Dept,IISGM, Madrid, Spain
Lorente-Omenaca, R:
Complejo Hosp Navarra, Dept Psychiat, Pamplona, Spain
Inst Invest Sanit Navarra IdiSNa, Pamplona, Spain
Amoretti, S:
Univ Barcelona, Hosp Clin Barcelona,Barcelona Clin Schizophrenia, August Pi & Sunyer Biomed Res Inst IDIBAPS, Neurosci Inst,Ctr Invest Biomed Red Salud Mental, Barcelona, Spain
Bernardo, M:
Univ Barcelona, Hosp Clin Barcelona,Barcelona Clin Schizophrenia, August Pi & Sunyer Biomed Res Inst IDIBAPS, Neurosci Inst,Ctr Invest Biomed Red Salud Mental, Barcelona, Spain
Cuesta, MJ:
Complejo Hosp Navarra, Dept Psychiat, Pamplona, Spain
Inst Invest Sanit Navarra IdiSNa, Pamplona, Spain
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