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Cognitive function in long term psychosis patients in a tertiary care hospital

Published online by Cambridge University Press:  26 August 2025

S. Shah*
Affiliation:
B.J. Medical College
K. Patel
Affiliation:
B.J. Medical College
A. Bhandari
Affiliation:
B.J. Medical College
A. Porwal
Affiliation:
B.J. Medical College
N. Lalwani
Affiliation:
B.J. Medical College
K. Khetani
Affiliation:
Department of Psychiatry, Civil Hospital, Ahmedabad, India
M. Parikh
Affiliation:
Department of Psychiatry, Civil Hospital, Ahmedabad, India
*
*Corresponding author.

Abstract

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Introduction

Psychosis refers to symptoms that are positive, disorganised,or negative and affects 3% of the population yet little information on long-term cognition is available.

Objectives

To determine association between symptom severity,duration of disease and cognitive impairment.

Methods

50 adult patients suffering from psychosis(DSM-5) for minimum 1 year and currently on at least 1 antipsychotic drug whose cognition and severity of symptoms were assessed by Montreal Cognitive Assessment test(MoCA) and Positive and Negative Syndrome Scale (PANSS) respectively were included in this cross sectional,cohort study.

Results

Mean age of population was 41.5±12.33 years.Disorganised behaviour and speech were the prevalent core symptoms and risperidone was the choice of drug.

Table 1MALEFEMALEP value T-testOverall mean
Total PANSS Score68.2 ± 27.575.2 ± 34.90.43071.1 ± 30.7
Positive PANSS15.3 ± 7.6717.4 ± 7.590.35716.2 ± 7.63
Negative PANSS17.2 ± 7.0618.3 ± 8.920.64617.7 ± 7.83
Generalised PANSS35.6 ± 14.739.5 ± 20.60.43437.2 ± 17.3
Table 2MALE (58%,n=29)FEMALE(42%,n=21)OVERALL(n=50)
Mild cognitive impairment(CI)34%(17)14%(7)48%(24)
Moderate CI24%(12)20%(10)44%(22)
Severe CI0%8%(4)8%(4)

Symptom severity was mild and more negative symptoms were prominent (composite score: -1.48±6.47) (Table 1 PANSS Score) and an overall moderate cognitive impairment(16.5±4.46, table 2) was seen in population. Females showed a significantly lower MoCA score as compared to males (14.9±4.8 vs 17.65 ± 3.78, p=0.03) implying more cognitive decline (image 3).There is a strong, negative, linear correlation between MoCA and PANSS scores (r= -0.688, p<0.001) wherein all domains(image 1)except memory were negatively correlated to PANSS. Duration of illness showed a moderate, positive,linear and weak, negative, linear correlation with PANSS( r= 0.417, p =0.003) and MoCA(r = -0.314, p= 0.026) respectively. PANSS items were negatively correlated to MoCA in positive, negative and generalised items except delusions, blunted effect and tension(image 2).

Image 1:

Image 2:

Image 3:

Conclusions

We conclude that cognitive function significantly declines( executive function was the most and memory was not significantly impacted) with respect to increasing disease severity and duration of illness in long term psychosis.Most positive symptoms, excluding delusions,and negative symptoms (apart from blunted affect) and general symptoms (except tension), were significantly linked to cognitive decline.

Disclosure of Interest

None Declared

Information

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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