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., 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)).

Individual changes over time in cognition in patients with psychotic disorders have been studied very little, especially in
the case of frst episode psychosis (FEP). We aimed to establish whether change in individual trajectories in cognition
over 2 years of a sample of 159 FEP patients was reliable and clinically signifcant, using the reliable change index (RCI)
and clinically signifcant change (CSC) methods. We also studied a sample of 151 matched healthy controls. Patients and
controls were assessed with a set of neuropsychological tests, as well as premorbid, clinical and functionality measures.
We analysed the course of cognitive measures over time, using analysis of variance, and the individual trajectories in the
cognitive measures with the regression-based RCI (RCISRB) and the CSC. The RCISRB showed that between 5.4 and 31.2%
of the patients showed deterioration patterns, and between 0.6 and 8.8% showed improvement patterns in these tests over
time. Patients showing better cognitive profles according to RCISRB (worsening in zero to two cognitive measures) showed
better premorbid, clinical and functional profles than patients showing deterioration patterns in more than three tests. When
combining RCISRB and CSC values, we found that less than 10% of patients showed improvement or deterioration patterns
in executive function and attention measures. These results support the view that cognitive impairments are stable over the
frst 2 years of illness, but also that the analysis of individual trajectories could help to identify a subgroup of patients with
particular phenotypes, who may require specifc interventions., This work was supported by the Carlos III Health Institute
(European Regional Development Funds-ERDF) of the Spanish Ministry of Economic Afairs and Competitiveness (08/1026, 11/02831,
14/01621) and the Health Department of the Government of Navarra
(87/2014).

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. 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. 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). Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.

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.