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Open Access 01-12-2020 | Schizophrenia | Original Contribution

Negative and disorganized symptoms mediate the relationship between verbal learning and global functioning in adolescents with early-onset psychosis

Authors: Runar Elle Smelror, Bjørn Rishovd Rund, Vera Lonning, Kjetil Nordbø Jørgensen, Kirsten Wedervang-Resell, Ole A. Andreassen, Torill Ueland, Anne M. Myhre, Ingrid Agartz

Published in: European Child & Adolescent Psychiatry | Issue 12/2020

Abstract

Neurocognitive deficits are associated with impaired global functioning and psychotic symptoms. However, whether symptoms can mediate the relationship between neurocognition and global functioning in adolescent psychosis is unclear. Here, we investigated if symptoms assessed with the Positive And Negative Syndrome Scale (PANSS), mediated the relationship between neurocognitive performance and global functioning in adolescents with non-affective early-onset psychotic disorders (EOP). Sixty-one adolescent EOP patients (age 12–18 years) from 2 Norwegian clinical cohorts were included. Linear regression models were applied to investigate associations between neurocognitive domains from the MATRICS Consensus Cognitive Battery (MCCB) and global functioning. PANSS symptoms were analyzed using the Wallwork/Fortgang five-factor model. Using the INDIRECT macro for SPSS, mediation effects were tested using bootstrapping with 95% bias corrected confidence intervals. Verbal learning was positively associated with global functioning (P < 0.001) and negatively associated with the disorganized symptom factor (P = 0.002), controlling for age, sex and cohort. Testing of indirect effects, controlling for age, sex and cohort, showed that the Negative (point estimate = 1.56, 95% CI 0.22, 3.47) and Disorganized (point estimate = 1.24, 95% CI 0.05, 3.69) symptom factors significantly mediated the relationship between verbal learning and global functioning. We found that verbal learning, negative and disorganized symptoms influenced global functioning in adolescents with EOP, while reality-distorted positive symptoms did not. These results suggest that assessing these domains in EOP is helpful for planning treatment and rehabilitation programs focusing on functional outcome.

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Title: Negative and disorganized symptoms mediate the relationship between verbal learning and global functioning in adolescents with early-onset psychosis
Authors: Runar Elle Smelror
Bjørn Rishovd Rund
Vera Lonning
Kjetil Nordbø Jørgensen
Kirsten Wedervang-Resell
Ole A. Andreassen
Torill Ueland
Anne M. Myhre
Ingrid Agartz
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keyword: Schizophrenia
Published in: European Child & Adolescent Psychiatry / Issue 12/2020
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI: https://doi.org/10.1007/s00787-020-01479-7

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Negative and disorganized symptoms mediate the relationship between verbal learning and global functioning in adolescents with early-onset psychosis

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