Cognitive Impairment in Schizophrenia Linked to Worse Disease Trajectory

Cognitive dysfunction in patients with schizophrenia is associated with unfavorable clinical outcomes.

Cognitive dysfunction may be a marker of poor clinical outcomes in schizophrenia, such as increased risk for hospitalization and more unique antipsychotic trials during the first year after diagnosis, according to study results presented at Psych Congress 2022, held September 17 to 20, 2022.

One of the core features of schizophrenia is cognitive impairment, which has been associated with poor functioning in the long term. Current treatments do not improve cognitive function in any clinically meaningful way.

For the study, researchers sought to evaluate common cognitive symptoms reported in electronic health records of patients with schizophrenia and to assess whether cognitive symptoms may be markers for poorer clinical outcomes. Researchers from Holmusk Technologies, Inc, sourced data from the NeuroBlu database, which contained de-identified electronic health records from centers in 25 states in the United States. Cognitive symptoms reported within 14 days of a diagnosis of schizophrenia were related with hospitalizations and drug trials.

The study population comprised 10,070 patients, among whom 28.1% had a clinician-reported cognitive symptom.

This finding adds further evidence that cognitive dysfunction may be a marker of a worse illness course in schizophrenia, and that development of novel treatments for this patient group should be a clinical priority.

Symptoms were reported as issues with attention or concentration (n=2064), general issues (n=995), issues with executive function (n=676), and issues with fund of knowledge (n=104).

After correcting for age, gender, ethnicity, antipsychotic medication, comorbid substance use disorder, and illness severity, the presence of cognitive symptoms was associated with increased risk for hospitalization (adjusted hazard ratio [aHR], 1.23; 95% CI, 1.16-1.31; P <.001) as well as increased antipsychotic drug trials in the first year following diagnosis (adjusted incremental risk ratio [aIRR], 1.11; 95% CI, 1.01-1.21; P =.02).

Study authors concluded, “This finding adds further evidence that cognitive dysfunction may be a marker of a worse illness course in schizophrenia, and that development of novel treatments for this patient group should be a clinical priority.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

References:

Patel R, Griffiths K, Ker S, Palmer EC. Associations between cognitive symptoms and poor clinical outcomes in schizophrenia: real-world evidence from an electronic health record study. Presented at Psych Congress 2022; September 17-20, 2022. New Orleans, LA. Abstract 130.