Spanish Journal of Psychiatry and Mental Health最新文献

{"title":"Genetic and epigenetic changes to the glucocorticoid receptor gene (NR3C1) and cognition in major depressive disorder.","authors":"Alex Ferrer, Javier Labad, Neus Salvat-Pujol, Mikel Urretavizcaya, Roser Obrador-Font, José M Menchón, Diego Palao, Carles Soriano-Mas, Javier Costas, Marta Barrachina, Ángel Carracedo, Virginia Soria","doi":"10.1016/j.sjpmh.2024.12.002","DOIUrl":"10.1016/j.sjpmh.2024.12.002","url":null,"abstract":"<p><strong>Introduction: </strong>Many studies have found that hypothalamic-pituitary-adrenal (HPA) axis abnormalities are related to the pathophysiology of major depressive disorder (MDD) and cognitive functioning. Our aim was to assess the influence of genetic polymorphisms and methylation levels in three different promoter regions throughout the glucocorticoid receptor (GR) gene NR3C1 on cognitive performance in MDD. Plausible interactions with childhood adversity and mediation relationships between genetic and epigenetic variables were explored.</p><p><strong>Materials and methods: </strong>The sample included a total of 64 MDD patients and 82 healthy controls. Child maltreatment and neurocognitive performance were assessed in all participants. HPA negative feedback was analyzed using the dexamethasone suppression test after the administration of 0.25mg of dexamethasone. A total of 23 single-nucleotide polymorphisms were genotyped, and methylation levels at several CpGs in exons 1D, 1F and 1H of the GR gene were measured.</p><p><strong>Results: </strong>Results show that, beyond the influence of other covariables, NR3C1 single-nucleotide polymorphisms and methylation levels predicted performance in executive functioning and working memory tasks. No significant interactions or mediation relationships were detected.</p><p><strong>Conclusions: </strong>Results suggest that genetic variations and epigenetic regulation of the GR gene are relevant factors influencing cognitive performance in MDD and could emerge as significant biomarkers and therapeutic targets in mood disorders and other stress-related disorders.</p>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic pathways and mortality across psychotic disorders: Evidence from Catalonia integrated health records.","authors":"Santiago Madero, Gerard Anmella, Michele De Prisco, Vincenzo Oliva, Clàudia Valenzuela-Pascual, Ariadna Mas, Giovanna Fico, Andrea Murru, Marc Valentí, Jordi Blanch, Clemente Garcia-Rizo, Vicent Llorca-Bofí, Silvia Amoretti, Norma Verdolini, Miquel Bioque, Eduard Parellada, Eduard Vieta, Diego Hidalgo-Mazzei","doi":"10.1016/j.sjpmh.2025.02.001","DOIUrl":"10.1016/j.sjpmh.2025.02.001","url":null,"abstract":"<p><strong>Introduction: </strong>Although psychotic disorders are associated with significant morbidity and mortality, the diagnostic trajectories and mortality risks across the spectrum of these disorders remain poorly understood. This study aimed to characterize diagnostic pathways and compare mortality outcomes across psychotic disorders in Catalonia.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using electronic health records of 357,007 adults accessing mental health services in Catalonia from 2015 through 2019. Diagnostic categories included schizophrenia, bipolar disorder, schizoaffective disorder, delusional disorder, other non-organic psychoses, unipolar psychotic depression, and other mental health diagnoses. Cox proportional hazards models assessed mortality risk, adjusting for sociodemographic factors and comorbidities.</p><p><strong>Results: </strong>About one-third of the sample received their first psychotic disorder diagnosis in specialized care. All psychotic disorders showed elevated mortality risk vs other mental health conditions. Schizophrenia had the highest risk (HR, 2.63; 95%CI, 2.46-2.81, p<0.001 followed by schizoaffective (HR, 1.99; 95%CI, 1.77-2.24, p<0.001) and delusional disorders (HR, 1.92; 95%CI, 1.66-2.21, p<0.001). Low socioeconomic status (HR, 3.69; 95%CI, 3.48-3.92, p<0.001) and comorbidities (HR, 1.82 per comorbidity; 95%CI, 1.81-1.83, p<0.001) were significant predictors of mortality across diagnoses. Gradient boosting machine modeling identified comorbidities (56.07%) and diagnostic category (24.51%) as top predictors of mortality risk.</p><p><strong>Conclusions: </strong>This study demonstrates significantly elevated mortality risk across the spectrum of psychotic disorders in a Southern European context, with socioeconomic factors and medical comorbidities emerging as critical determinants. These findings underscore the need for integrated care approaches addressing both mental and physical health needs in psychotic disorders.</p>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient's determinants of subjective and objective burden in caregivers of people with first episode psychosis","authors":"Imke Dachs ,&nbsp;Marcia Irazabal ,&nbsp;Helena García-Mieres ,&nbsp;Nuria Del Cacho ,&nbsp;Judith Usall ,&nbsp;Ana Barajas ,&nbsp;Montserrat Dolz ,&nbsp;Bernardo Sánchez ,&nbsp;Iris Baños ,&nbsp;Elena Huerta-Ramos ,&nbsp;Silvia Marco-García ,&nbsp;Janina Carlson ,&nbsp;Marta Coromina ,&nbsp;GENIPE GROUP and Susana Ochoa","doi":"10.1016/j.rpsm.2022.04.003","DOIUrl":"10.1016/j.rpsm.2022.04.003","url":null,"abstract":"<div><h3>Background</h3><div>Understanding if there are differential determinants of objective and subjective burdening in caregivers of first episode psychosis (FEP) patients would be essential to optimize current early support programs. Our aim was to elucidate the clinical and sociodemographic characteristics of FEP patients that influence the objective and subjective burdening of their informal caregivers.</div></div><div><h3>Materials and methods</h3><div>75 participants with FEP were assessed in social functioning and psychotic symptoms. Their caregivers were assessed with an instrument of objective and subjective family burden. Objective burdening was assessed in terms of time spent. Subjective burden was assessed in terms of worry experienced.</div></div><div><h3>Results</h3><div><span>Regression analyses<span> showed that impaired social functioning of the patient was the major determinant of family burdening, in assisting in daily activities and containing disrupted behavior. Excitative symptoms were more determinant than </span></span>positive symptoms in explaining burdening when containing disrupted behavior. A younger age of the patient specifically determined higher subjective but not objective burdening. Economic incomes had little contribution to family burdening.</div></div><div><h3>Conclusions</h3><div>Our results suggest that there may not be differential determinants of objective and subjective burdening on domains of family burdening in FEP. Current multicomponent early interventions may consider social functioning and excitative symptoms the factors that may focus on to reduce both objective and subjective family burdening. Caregivers of youngest patients may need additional psychological support as they care of patients with higher dependency level and involving more subjective burdening.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"18 2","pages":"Pages 72-79"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72947179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individualized pretest risk estimates to guide treatment decisions in patients with clinical high risk for psychotic disorders","authors":"Elodie Sprüngli-Toffel ,&nbsp;Erich Studerus ,&nbsp;Logos Curtis ,&nbsp;Caroline Conchon ,&nbsp;Luis Alameda ,&nbsp;Barbara Bailey ,&nbsp;Camille Caron ,&nbsp;Carmina Haase ,&nbsp;Julia Gros ,&nbsp;Evelyn Herbrecht ,&nbsp;Christian G. Huber ,&nbsp;Anita Riecher-Rössler ,&nbsp;Philippe Conus ,&nbsp;Alessandra Solida ,&nbsp;Marco Armando ,&nbsp;Afroditi Kapsaridi ,&nbsp;Mathieu Mercapide Ducommun ,&nbsp;Paul Klauser ,&nbsp;Kerstin Jessica Plessen ,&nbsp;Sébastien Urben ,&nbsp;Christina Andreou","doi":"10.1016/j.sjpmh.2024.09.001","DOIUrl":"10.1016/j.sjpmh.2024.09.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Clinical high risk for psychosis (CHR) states are associated with an increased risk of transition to psychosis. However, the predictive value of CHR screening interviews is dependent on pretest risk enrichment in referred patients. This poses a major obstacle to CHR outreach campaigns since they invariably lead to risk dilution through enhanced awareness. A potential compensatory strategy is to use estimates of individual pretest risk as a ‘gatekeeper’ for specialized assessment. We aimed to test a risk stratification model previously developed in London, UK (OASIS) and to train a new predictive model for the Swiss population.</div></div><div><h3>Method</h3><div>The sample was composed of 513 individuals referred for CHR assessment from six Swiss early psychosis detection services. Sociodemographic variables available at referral were used as predictors whereas the outcome variable was transition to psychosis.</div></div><div><h3>Results</h3><div>Replication of the risk stratification model developed in OASIS resulted in poor performance (Harrel's <em>c</em> <!-->=<!--> <!-->0.51). Retraining resulted in moderate discrimination (Harrel's <em>c</em> <!-->=<!--> <!-->0.67) which significantly differentiated between different risk groups. The lowest risk group had a cumulative transition incidence of 6.4% (CI: 0–23.1%) over two years.</div></div><div><h3>Conclusion</h3><div>Failure to replicate the OASIS risk stratification model might reflect differences in the public health care systems and referral structures between Switzerland and London. Retraining resulted in a model with adequate discrimination performance. The developed model in combination with CHR assessment result, might be useful for identifying individuals with high pretest risk, who might benefit most from specialized intervention.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"18 2","pages":"Pages 133-140"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternity in women with schizophrenia and schizoaffective disorder","authors":"Gemma Safont ,&nbsp;Marina Garriga ,&nbsp;Alexandre González-Rodríguez ,&nbsp;Silvia Amoretti ,&nbsp;Olga Simón ,&nbsp;Eva Solè ,&nbsp;Clemente Garcia-Rizo ,&nbsp;Belén Arranz ,&nbsp;Eduard Vieta ,&nbsp;Miquel Bernardo","doi":"10.1016/j.sjpmh.2023.04.002","DOIUrl":"10.1016/j.sjpmh.2023.04.002","url":null,"abstract":"<div><h3>Purpose</h3><div><span>Maternity rates in women with schizophrenia have tripled in the past decades, with a current percentage similar to the general population (50–60%). However, mothers with schizophrenia present higher rates of single marital status, and social dysfunction than the general population. In addition, the incidence of </span>unplanned pregnancy<span>, abortions, miscarriages and obstetric complications is higher.</span></div><div>This study aimed to describe variables related to maternity in this population.</div></div><div><h3>Methods</h3><div><span>One-hundred and ninety-two outpatient women diagnosed with schizophrenia and schizoaffective disorders were included (DSM-IV-TR criteria) in a two-site study. Psychosocial risk factors, demographic variables and </span>clinical features were recorded in the same visit. Non-parametric tests were used in order to describe variables for likelihood offspring in psychotic women.</div></div><div><h3>Results</h3><div>One-hundred and forty-seven (76.6%) women suffered from schizophrenia and 45 (23.4%) schizoaffective disorder. Psychotic mothers used to be married/having a partner and presented a later onset of the illness (over 36 years old) compared to non-mothers. In addition, mothers generally presented pregnancy before the onset of illness. Regarding obstetric complications, around the 80% of the sample presented at least one obstetric complication. Although desire or wish of pregnancy was reported in 66.3% of the mothers, rates of planned pregnancy were 25% and only the 47.9% were currently taking care of their children with their husband/partner.</div></div><div><h3>Conclusion</h3><div><span>Maternity rate is high in this population. This study highlights the need to promote reproductive health care for women with </span>mental disorders and to consider their reproductive life plan.</div><div>Later onset of disease and being married are potential predictors of maternity in our sample of women with a schizophrenia and schizoaffective disorders while only the half were caring their children at the moment of the evaluation.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"18 2","pages":"Pages 106-110"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135890038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting first-episode psychosis and schizophrenia through a multidimensional and longitudinal lens","authors":"Benedicto Crespo-Facorro ,&nbsp;Emilio Fernandez-Egea","doi":"10.1016/j.sjpmh.2025.06.001","DOIUrl":"10.1016/j.sjpmh.2025.06.001","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"18 2","pages":"Pages 65-66"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco use disorder and other mental disorders: The neglected dual disorder","authors":"Carlos Parro-Torres ,&nbsp;Miquel Casas ,&nbsp;José Martínez-Raga ,&nbsp;Ma Cristina Pinet Ogué ,&nbsp;Pilar Alejandra Sáiz Martínez ,&nbsp;Néstor Szerman","doi":"10.1016/j.sjpmh.2024.04.002","DOIUrl":"10.1016/j.sjpmh.2024.04.002","url":null,"abstract":"","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"18 2","pages":"Pages 67-69"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theory of Mind as an endophenotype for schizophrenia spectrum disorder: Study in first episode of psychosis patients and first-degree relatives","authors":"Georgelina Abreu-Fernández ,&nbsp;Nancy Murillo-García ,&nbsp;Víctor Ortiz-García de la Foz ,&nbsp;Rebeca Magdaleno Herrero ,&nbsp;Ángel Yorca-Ruiz ,&nbsp;Rosa Ayesa-Arriola","doi":"10.1016/j.sjpmh.2023.09.004","DOIUrl":"10.1016/j.sjpmh.2023.09.004","url":null,"abstract":"<div><h3>Background</h3><div><span>Deficits in Theory of Mind (ToM) had been suggested as a possible </span>endophenotype for unaffected relatives of first episode of psychosis (FEP) patients. There are a limited number of studies which have evaluated ToM deficits among the siblings and parents of FEP patients.</div></div><div><h3>Aim</h3><div>This study aimed to explore ToM deficits and its correlates among FEP patients, their siblings, parents, and controls.</div></div><div><h3>Methodology</h3><div>FEP patients (<em>N</em> <!-->=<!--> <!-->102), their parents (<em>N</em> <!-->=<!--> <!-->135), siblings (<em>N</em> <!-->=<!--> <!-->97), and controls (<em>N</em> <!-->=<!--> <!-->167) were evaluated on ToM performance with the Reading the Mind in the Eyes Test (Eyes Test). Interview for sociodemographic variables of age, sex, years of education, and IQ estimation and neurocognitive tests were administered to all groups.</div></div><div><h3>Results</h3><div>FEP patients had a significantly lower performance on the Eyes Test compared to their siblings and controls. However, no significant differences were found between siblings and parents or siblings and controls.</div></div><div><h3>Conclusion</h3><div>Attending our results, we found no evidence for ToM deficits as an endophenotype of SSDs. Furthermore, ToM accuracy may be mediated by interaction with other cognitive domains and play a protective role against psychosis in unaffected siblings.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"18 2","pages":"Pages 100-105"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135706848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased risk of early lung function alterations in people with psychosis: A cross-sectional case–control study","authors":"Ana Viejo Casas ,&nbsp;Carlos Amado Diago ,&nbsp;Juan Agüero Calvo ,&nbsp;Marcos Gómez-Revuelta ,&nbsp;Paula Suarez Pinilla ,&nbsp;Claudia Ovejas Catalán ,&nbsp;Paloma Fuentes Pérez ,&nbsp;Mario Ruiz Núñez ,&nbsp;Roberto Garrastazu López ,&nbsp;María Juncal Ruiz ,&nbsp;Benedicto Crespo-Facorro ,&nbsp;Javier Vázquez-Bourgon","doi":"10.1016/j.sjpmh.2023.10.004","DOIUrl":"10.1016/j.sjpmh.2023.10.004","url":null,"abstract":"<div><h3>Background</h3><div>Tobacco smoking has been described as the main cause of chronic obstructive pulmonary disease (COPD) and this habit is clearly more frequent among individuals with psychosis than in the general population, with rates reaching up to 60%. However, little attention has been focused on the association of COPD and psychosis. We aimed to explore the risk of presenting early lung function alterations in a group of individuals with psychosis.</div></div><div><h3>Methods</h3><div>Following an observational cross-sectional design we studied a cohort of individuals with established psychosis (<em>N</em> <!-->=<!--> <!-->128), and compared them with a sex, age, and smoking habit matched control group (<em>N</em> <!-->=<!--> <span>79). We evaluated respiratory symptoms by means of mMRC<span>, CAT and Dyspnea-12 scales. And lung function through spirometry tests.</span></span></div></div><div><h3>Results</h3><div><span>Individuals with psychosis presented more respiratory symptoms than controls. Similarly, we observed significant differences in the lung function tests between these two groups, where individuals with psychosis presented worse results in most of the spirometry mean values (FEV</span>₁ or forced expiratory volume in the first one second: 3.29<!--> <!-->L vs. 3.75<!--> <!-->L, <em>p</em> <!-->&lt;<!--> <span>0.001; forced vital capacity or FVC: 4.25</span> <!-->L vs. 4.72<!--> <!-->L, <em>p</em> <!-->=<!--> <!-->0.002; and FEV₁/FVC ratio: 0.78 vs. 0.80, <em>p</em> <!-->=<!--> <span><span>0.052). Patients also presented worse values of lung diffusion<span>, with lower diffusing capacity for </span></span>carbon monoxide (DLCO) than controls (6.95 vs. 8.54</span> <!-->mmol/min/kPa, <em>p</em> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>The individuals with psychosis in our study presented greater respiratory symptoms and poorer lung function measured through spirometry. These signs have been described as early signs of COPD.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"18 2","pages":"Pages 111-115"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term trajectories of clinical staging in first-episode psychosis and their associated cognitive outcome: A 21-year follow-up study","authors":"Manuel J. Cuesta ,&nbsp;Ana M. Sánchez-Torres ,&nbsp;Lucia Moreno-Izco ,&nbsp;Elena García de Jalón ,&nbsp;Gustavo J. Gil-Berrozpe ,&nbsp;Victor Peralta","doi":"10.1016/j.sjpmh.2024.02.001","DOIUrl":"10.1016/j.sjpmh.2024.02.001","url":null,"abstract":"<div><div>Cognitive deficits are already present before psychosis onset but are a key feature of first-episode psychosis (FEP). The objective of this study was to investigate the cognitive outcomes of a cohort of FEP patients who were diagnosed using the clinical staging approach and were followed for up to 21 years.</div><div>We analyzed data from 173 participants with first-admission psychosis who were followed-up for a mean of 20.9 years. The clinical staging assessment was adapted from the clinical staging framework developed by McGorry et al.<span><span>¹</span></span> Cognitive assessment was performed using the MATRICS Consensus Cognitive Battery (MMCB) at the end of follow-up.</div><div>FEP patients who were longitudinally diagnosed in the lowest clinical stages (stages 2A and 2B) showed better performance in attention, processing speed, and MCCB overall composite score than those in the highest clinical stages (stages 4A and 4B). There was a significant linear trend association between worsening of all MCCB cognitive functions and MCCB overall composite score and progression in clinical staging. Furthermore, the interval between two and five years of follow-up appears to be associated with deficits in processing speed as a cognitive marker.</div><div>Our results support the validation of the clinical staging model over a long-term course of FEP based on neuropsychological performance. A decline in some cognitive functions, such as processing speed, may facilitate the transition of patients to an advanced stage during the critical period of first-episode psychosis.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"18 2","pages":"Pages 116-124"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}