Cognitive change 5+ years since the onset of a psychotic disorder: A systematic review and meta-analysis
Bibliographic record
Abstract
Abstract Cognitive impairments are a core feature of psychotic disorders, but their long-term trajectory remains contentious. Previous meta-analyses focused on the first 5 years following psychosis onset. Here, we evaluated the change in cognitive impairments in psychotic disorders with a meta-analysis of studies with follow-ups of 5+ years. Following preregistration, databases were searched for relevant articles until July 2024. Two authors screened the reports for studies reporting on the change in cognitive impairments in global cognition, verbal learning and memory, visual learning and memory, working memory, attention, speed of processing, reasoning and problem-solving, and verbal fluency in individuals with psychotic disorders, with a minimum follow-up of 5 years. Three authors extracted data, and the PRISMA guidelines were followed. Random-effects meta-analyses and moderator analyses were conducted. Twenty-four studies comprising 2,633 patients and 1,019 controls were included in the study. Over an average of 8.46 years, cognitive impairments remained stable in all eight measures: global cognition ( g = 0.09; 95% CI = 0.03–0.20), verbal memory ( g = 0.05; 95% CI = −0.11, 0.21), visual memory ( g = −0.16; 95% CI = −0.35, 0.03), working memory ( g = 0.03; 95% CI = −0.09, 0.14), attention ( g = 0.22; 95% CI = −0.36, 0.80), speed of processing ( g = 0.10; 95% CI = −0.14, 0.35), reasoning and problem-solving ( g = 0.16; 95% CI = −0.03, 0.35), and verbal fluency ( g = 0.08; 95% CI = −0.03, 0.19). We conclude that cognitive impairments remain stable over time, consistent with the neurodevelopmental view of psychotic disorders.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.028 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.047 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".