학술논문
Working memory deterioration as an early warning sign for relapse in remitted psychosis: A one-year naturalistic follow-up study.
Document Type
Academic Journal
Author
Tao TJ; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong.; Hui CLM; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong. Electronic address: christy@lmhui.com.; Hui PWM; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong.; Ho ECN; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong.; Lam BST; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong.; Wong AKH; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong.; See SHW; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong.; Chan EWT; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong.; Suen YN; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong.; Lee EHM; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong.; Chan SKW; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong.; Chang WC; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong.; Lo WTL; Department of Psychiatry, Kwai Chung Hospital, Hong Kong.; Chong CSY; Department of Psychiatry, Kwai Chung Hospital, Hong Kong.; Siu CMW; Department of Psychiatry, Kwai Chung Hospital, Hong Kong.; Choi YY; Department of Psychiatry, Kwai Chung Hospital, Hong Kong.; Pomarol-Clotet E; FIDMAG Germanes Hospitalaries Research Foundation - CIBERSAM, ISCIII, Barcelona, Spain.; McKenna PJ; FIDMAG Germanes Hospitalaries Research Foundation - CIBERSAM, ISCIII, Barcelona, Spain.; Honer WG; Department of Psychiatry, University of British Columbia, Vancouver, Canada.; Chen EYH; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong.
Source
Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Ireland NLM ID: 7911385 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-7123 (Electronic) Linking ISSN: 01651781 NLM ISO Abbreviation: Psychiatry Res Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Relapse prevention is an important goal in the clinical management of psychosis. Cognitive deficits/deterioration can provide useful insights for monitoring relapse in psychosis patients.
Methods: This was a prospective, naturalistic 1-year follow-up study involving 110 psychosis patients with full clinical remission. Relapse, defined as the recurrence of psychotic symptoms, was monitored monthly along with digital tracking of verbal and visual working memory using a mobile app developed for this study. Cognitive deterioration was defined as worsening performance over 2 months prior to relapse or study termination, whichever was earlier. Other clinical, cognitive, functioning, and psychosocial variables were also collected.
Results: At 1 year, 18 (16.36%) patients relapsed, of which 6 (33.33%) required hospitalization. Relapse was predicted by verbal working memory deterioration 2 months prior to relapse (p = 0.029), worse medication adherence (p = 0.018), and less resilience (p = 0.014).
Conclusions: Verbal working memory deterioration is a novel early sign of relapse. It is a clearly defined, objectively measurable, and reproducible marker that can help clinicians and healthcare workers identify patients at risk of relapse and make decisions about maintenance therapy. Moreover, digital monitoring is a viable tool in the management of relapse.
Competing Interests: Declaration of Competing Interest EYHC reports having received speaker honoraria from Otsuka and DSK BioPharma; received research funding from Otsuka; participated in paid advisory boards for Jansen and DSK BioPharma; and received funding to attend conferences from Otsuka and DSK BioPharma. The remaining authors declare no competing interests.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Methods: This was a prospective, naturalistic 1-year follow-up study involving 110 psychosis patients with full clinical remission. Relapse, defined as the recurrence of psychotic symptoms, was monitored monthly along with digital tracking of verbal and visual working memory using a mobile app developed for this study. Cognitive deterioration was defined as worsening performance over 2 months prior to relapse or study termination, whichever was earlier. Other clinical, cognitive, functioning, and psychosocial variables were also collected.
Results: At 1 year, 18 (16.36%) patients relapsed, of which 6 (33.33%) required hospitalization. Relapse was predicted by verbal working memory deterioration 2 months prior to relapse (p = 0.029), worse medication adherence (p = 0.018), and less resilience (p = 0.014).
Conclusions: Verbal working memory deterioration is a novel early sign of relapse. It is a clearly defined, objectively measurable, and reproducible marker that can help clinicians and healthcare workers identify patients at risk of relapse and make decisions about maintenance therapy. Moreover, digital monitoring is a viable tool in the management of relapse.
Competing Interests: Declaration of Competing Interest EYHC reports having received speaker honoraria from Otsuka and DSK BioPharma; received research funding from Otsuka; participated in paid advisory boards for Jansen and DSK BioPharma; and received funding to attend conferences from Otsuka and DSK BioPharma. The remaining authors declare no competing interests.
(Copyright © 2022 Elsevier B.V. All rights reserved.)