Relations between Neurocognition, Theory of Mind and Functional Outcome in Patients with a First-Episode of Schizophrenia and Gender Differences at 3-year follow-up

Abstract

Introduction: Neurocognitive impairments and deficits in theory of mind (understating one`s and other`s mental states) are enhanced in patients with schizophrenia. Such impairments have been observed also in first-episode patients. Inevitably, arises the need to know about the effects that these impairments can cause to patient`s everyday functioning. Also, several studies suggest that there are differences due to gender. The purpose of this work was to study the longitudinal relations (over the course of 3 years) of neurocognition, theory of mind (ToM) and functional outcome in patients who were going through a first-episode of schizophrenia. Methods: Records from 100 patients with a first episode of schizophrenia, treated at the Marques de Valdecilla Hospital in Santander Spain, were included in this study. The information was provided by the Program of Attention Phases Initial Psychosis (PAFIP) in this hospital. All the data: neurocognition (Neuropsychological Assesment Battery), ToM (Reading the mind in the eyes, Eye-task) and functionality (Disability Assessment Scale, DAS), were collected from professionals. For the statistical analysis, the SPSS-22 computer application was used. Results: Among neurocognitive variables, at baseline, the Working Memory was the one that has the most significant relation with the DAS items (a total of 7 out of 15). At 3-year follow-up Global DAS is significantly (p <.05) related to five variables: Working Memory, Attention, Verbal Memory, Premorbid IQ and Motor Dexterity (positive correlation: p = .314). ToM does not present any statistically significant relation with Functional Outcome (DAS). Analysis about gender differences showed significant difference on DAS total score (p <.05), with higher scores for men, in comparison to women (2.26 vs. 1.54). Conclusions: In conclusion, at the 3-year follow-up, patients with a first episode of schizophrenia showed better global functioning than at baseline. Specifically, at follow-up, general outcome functioning is related to Working Memory, Verbal Memory, Attention, Motor Dexterity, and Premorbid IQ. Differently, from ToM, neurocognition was related to functional outcome at both time-points. Regarding gender differences, at baseline women showed better global function than men, but this difference did not appear at the follow-up assessment.The present work could help further investigations or treatment interventions about which domains are strongly related to functional outcome in patients with a first-episode of schizophrenia.