There are varying cognitive trajectories over 20 years among individuals with schizophrenia spectrum disorders, according to a study published online on Feb. 12 in Psychological Medicine.

Marie Starzer, M.D., from the Copenhagen Research Center for Mental Health and the University of Copenhagen in Denmark, and colleagues assessed whether cognitive deficits progress over time in individuals with schizophrenia. The analysis included 20-year follow-up of 156 participants from the OPUS I trial.

The researchers found that 30.5 percent of patients had a declining course of neurocognition, 49.2 percent had a stable course of neurocognition, and 20.3 percent experienced improvements in neurocognition. At the 20-year follow-up, good cognitive functioning was significantly associated with higher levels of social functioning. Increasing experiential negative symptoms at follow-up were significantly correlated to cognitive worsening.

Declining neurocognition was predicted by younger age at inclusion and a low level of education (less than 10 years).

"Our findings support the notion of different schizophrenia subtypes with varying trajectories," the authors write. "Neurocognitive impairment at the 20-year follow-up was associated with other poor outcomes, highlighting the importance of treatments aimed at improving neurocognition in patients with schizophrenia spectrum disorders."

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