Roger Carlsson

Neuropsyhological Aspects of First Episode Psychosis: Diagnosis, Course and Outcome Roger Carlsson

The book aims to clarify neuropsychological functions in first episode psychosis patients (FEP). Patients from the Swedish multicenter study, the Parachute Project, were examined using the WAIS-R NI test battery, in relation to measures of outcome in terms of clinical, psychological and social parameters. In the project, patients were offered "need-adapted" treatment and follow up for five years, based on out-patient care in order to positively affect long-term outcome. One main finding was that cognitive functions, i.e. Fullscale IQ, examined shortly after onset of psychosis, significantly predicted presence of negative symptoms year one, and functional outcome years three and five. No specific neuropsychological profile has yet been found, but impairments in cognition are characteristic of the acute state of the psychotic illness. Cognitive deficits appear to be a trait feature in patients with poor prognosis, e.g. those who later develop schizophrenia, and may also be present in phases of symptoms in remission, although still functionally impaired. Cognitive functions are suggested to be included in the proposed remission criteria for FEP patients.