BUSCADOR RECOLECTA

Background. Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years.
Methods. The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis.
Results. At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (-10.215 to -0.337) and (-4.731 to -0.605) respectively).
Conclusions. Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.

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., This study is part of a coordinated, multicentre project funded by the Ministerio de Economía y Competitividad (PI08/0208; 08/1026; 11/02831; PI08/1161; PI14/1621), Instituto de Salud Carlos III-Fondo Europeo de Desarrollo Regional, and European Union. Una manera de hacer Europa (FEDER Funds). The Health Department of the Government of Navarra (87/2014). CERCA Programme/Generalitat de Catalunya; Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement (2014|SGR1636, 2014SGR441) and Fundación Alicia Koplowitz.

Background. Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years. Methods The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis. Results. At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (—10.215 to —0.337) and (—4.731 to —0.605) respectively). Conclusions. Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship., This work was supported by the Carlos III Institute of
Health and European Fund for Regional Development (PI08/1213, PI11/
01977, PI14/01900, PI08/01026, PI11/02831, PI14/01621, PI08/1161, PI16/
00359, PI16/01164, PI18/00805), the Basque Foundation for Health Innovation
and Research (BIOEF), the Secretaria d´Universitats I Recerca del
Departament d´Economia I Coneixement (2017 SGR 1365), and R&D activities
in Biomedicine, Madrid Regional Government and Structural Funds of the
European Union (S2017/BMD-3740 (AGES-CM 2-CM)).