The Relative Contribution of Cognition and Symptomatic Remission to Functional Outcome Following Treatment of a First Episode of Psychosis (FEP)
Bibliographic record
Abstract
Objective: Functional recovery remains the primary goal following treatment of a psychotic disorder, especially after a first episode.Evidence regarding relative contributions of predictors of functional outcome, including symptoms and cognition, remains equivocal.The objective of the study was to determine the relative contribution of cognition, in particular verbal memory, and symptomatic remission to social and occupational functioning while controlling for established predictors of functioning in a large sample of patients presenting with a first episode (FE) of a schizophrenia spectrum or affective psychosis.Methods: Patients (aged 14-35) who met DSM-IV criteria for a first episode of a schizophrenia spectrum or affective psychosis and had been admitted to the Prevention and Early Intervention Program for Psychoses, Montréal, between 2003-2009 for treatment and follow-up for two years.Established predictors (DUP, medication adherence, age of onset, substance use, premorbid adjustment), verbal memory and length of positive and negative symptom remission were regressed on functioning (using the Strauss Carpenter Scale) at one (n =208) and two (n=159) years.Regressions were conducted with established predictors in the first step, followed by verbal memory and consecutive months of combined positive and negative symptom remission in the third step.Regressions were then repeated with length of positive and negative symptom remission, respectively.Results: Length of combined positive and negative symptom remission explained the most variance in functioning at one {R² adj =.35, F(9,129)=9.33, p <.001} and two {R² adj = .38F(9,97)=8.21,p <.001} years, and verbal memory contributed only slightly to such outcome.While length of remission of negative symptoms was a stronger predictor of functioning than remission of positive symptoms at Cognition and Remission 4 1 year, length of positive symptom remission also made a large contribution at two years.Conclusions: These results highlight the importance of achieving and maintaining remission of both negative and positive symptoms for longer periods in FEP patients and the need for effective interventions to do so.
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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 | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".