Neurocognitive outcomes in the treatment of early-onset Schizophrenia Spectrum Disorders study

Jean A. Frazier, Anthony J. Giuliano, Jacqueline L. Johnson, Lauren Yakutis, Eric A. Youngstrom, David Breiger, Linmarie Sikich, Robert L. Findling, Jon McClellan, Robert M. Hamer, Benedetto Vitiello, Jeffrey A. Lieberman, Stephen R. Hooper

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To assess neurocognitive outcomes following antipsychotic intervention in youth enrolled in the National Institute of Mental Health (NIMH)-funded Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS). Method: Neurocognitive functioning of youth (ages 8 to 19 years) with schizophrenia or schizoaffective disorder was evaluated in a four-site, randomized, double-blind clinical trial comparing molindone, olanzapine, and risperidone. The primary outcomes were overall group change from baseline in neurocognitive composite and six domain scores after 8 weeks and continued treatment up to 52 weeks. Age and sex were included as covariates in all analyses. Results: Of 116 TEOSS participants, 77 (66%) had post-baseline neurocognitive data. No significant differences emerged in the neurocognitive outcomes of the three medication groups. Therefore, the three treatment groups were combined into one group to assess overall neurocognitive outcomes. Significant modest improvements were observed in the composite score and in three of six domain scores in the acute phase, and in four of six domain scores in the combined acute and maintenance phases. Partial correlation analyses revealed very few relationships among Positive and Negative Syndrome Scale (PANSS) baseline or change scores and neurocognition change scores. Conclusions: Antipsychotic intervention in youth with early-onset schizophrenia spectrum disorders (EOSS) led to modest improvement in measures of neurocognitive function. The changes in cognition were largely unrelated to baseline symptoms or symptom change. Small treatment effect sizes, easily accounted for by practice effects, highlight the critical need for the development of more efficacious interventions for the enduring neurocognitive deficits seen in EOSS.

Original languageEnglish (US)
Pages (from-to)496-505
Number of pages10
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume51
Issue number5
DOIs
StatePublished - May 2012

Keywords

  • antipsychotics
  • early-onset
  • neurocognition
  • outcomes
  • schizophrenia

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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