Prevalence, profile and associations of cognitive impairment in Ugandan first-episode psychosis patients
Introduction: The MATRICS consensus cognitive battery (MCCB) is the gold standard for neuropsychological assessment in psychotic disorders but is rarely used in low resource settings. This study used the MCCB to determine the prevalence, profile and associations of various exposures with cognitive i...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Schizophrenia Research: Cognition |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221500132100041X |
| _version_ | 1818338704115105792 |
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| author | Emmanuel K. Mwesiga Reuben Robbins Dickens Akena Nastassja Koen Juliet Nakku Noeline Nakasujja Dan J. Stein |
| author_facet | Emmanuel K. Mwesiga Reuben Robbins Dickens Akena Nastassja Koen Juliet Nakku Noeline Nakasujja Dan J. Stein |
| author_sort | Emmanuel K. Mwesiga |
| collection | DOAJ |
| description | Introduction: The MATRICS consensus cognitive battery (MCCB) is the gold standard for neuropsychological assessment in psychotic disorders but is rarely used in low resource settings. This study used the MCCB to determine the prevalence, profile and associations of various exposures with cognitive impairment in Ugandan first-episode psychosis patients. Methods: Patients and matched healthy controls were recruited at Butabika Hospital in Uganda. Clinical variables were first collated, and after the resolution of psychotic symptoms, a neuropsychological assessment of seven cognitive domains was performed using the MCCB. Cognitive impairment was defined as two standard deviations (SD) below the mean in one domain or 1SD below the mean in two domains. Descriptive statistics determined the prevalence and profile of impairment while regression models determined the association between various exposures with cognitive scores while controlling for age, sex and education. Results: Neuropsychological assessment with the MCCB found the burden of cognitive impairment in first-episode psychosis patients five times that of healthy controls. The visual learning and memory domain was most impaired in first-episode psychosis patients, while it was the working memory domain for the healthy controls. Increased age was associated with impairment in the domains of the speed of processing (p < 0.001) and visual learning and memory (p = 0.001). Cassava-rich diets and previous alternative and complementary therapy use were negatively associated with impairment in the visual learning (p = 0.04) and attention/vigilance domains (p = 0.012), respectively. There were no significant associations between sex, history of childhood trauma, or illness severity with any cognitive domain. Conclusion: A significant burden of cognitive impairment in Ugandan first-episode psychosis patients is consistent with prior data from other contexts. However, the profile of and risk factors for impairment differ from that described in such work. Therefore, interventions to reduce cognitive impairment in FEP patients specific to this setting, including dietary modifications, are required. |
| first_indexed | 2024-12-13T15:15:20Z |
| format | Article |
| id | doaj.art-591a83b34d4c447693a35880470dcb4e |
| institution | Directory Open Access Journal |
| issn | 2215-0013 |
| language | English |
| last_indexed | 2024-12-13T15:15:20Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Schizophrenia Research: Cognition |
| spelling | doaj.art-591a83b34d4c447693a35880470dcb4e2022-12-21T23:40:43ZengElsevierSchizophrenia Research: Cognition2215-00132022-06-0128100234Prevalence, profile and associations of cognitive impairment in Ugandan first-episode psychosis patientsEmmanuel K. Mwesiga0Reuben Robbins1Dickens Akena2Nastassja Koen3Juliet Nakku4Noeline Nakasujja5Dan J. Stein6Department of Psychiatry, Makerere University, Uganda; Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Corresponding author at: Department of Psychiatry and Mental Health, University of Cape Town, South Africa.Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, United StatesDepartment of Psychiatry, Makerere University, UgandaDepartment of Psychiatry and Mental Health, University of Cape Town, South Africa; SA MRC Research Unit on Risk & Resilience in Mental Disorders, Cape Town, South AfricaButabika National Referral Mental Hospital, UgandaDepartment of Psychiatry, Makerere University, UgandaDepartment of Psychiatry and Mental Health, University of Cape Town, South Africa; Neuroscience Institute, University of Cape Town, South AfricaIntroduction: The MATRICS consensus cognitive battery (MCCB) is the gold standard for neuropsychological assessment in psychotic disorders but is rarely used in low resource settings. This study used the MCCB to determine the prevalence, profile and associations of various exposures with cognitive impairment in Ugandan first-episode psychosis patients. Methods: Patients and matched healthy controls were recruited at Butabika Hospital in Uganda. Clinical variables were first collated, and after the resolution of psychotic symptoms, a neuropsychological assessment of seven cognitive domains was performed using the MCCB. Cognitive impairment was defined as two standard deviations (SD) below the mean in one domain or 1SD below the mean in two domains. Descriptive statistics determined the prevalence and profile of impairment while regression models determined the association between various exposures with cognitive scores while controlling for age, sex and education. Results: Neuropsychological assessment with the MCCB found the burden of cognitive impairment in first-episode psychosis patients five times that of healthy controls. The visual learning and memory domain was most impaired in first-episode psychosis patients, while it was the working memory domain for the healthy controls. Increased age was associated with impairment in the domains of the speed of processing (p < 0.001) and visual learning and memory (p = 0.001). Cassava-rich diets and previous alternative and complementary therapy use were negatively associated with impairment in the visual learning (p = 0.04) and attention/vigilance domains (p = 0.012), respectively. There were no significant associations between sex, history of childhood trauma, or illness severity with any cognitive domain. Conclusion: A significant burden of cognitive impairment in Ugandan first-episode psychosis patients is consistent with prior data from other contexts. However, the profile of and risk factors for impairment differ from that described in such work. Therefore, interventions to reduce cognitive impairment in FEP patients specific to this setting, including dietary modifications, are required.http://www.sciencedirect.com/science/article/pii/S221500132100041XCognitive impairmentFirst-episode psychosisMATRICS consensus cognitive batteryLow-income countryUgandaNeuropsychological assessment |
| spellingShingle | Emmanuel K. Mwesiga Reuben Robbins Dickens Akena Nastassja Koen Juliet Nakku Noeline Nakasujja Dan J. Stein Prevalence, profile and associations of cognitive impairment in Ugandan first-episode psychosis patients Schizophrenia Research: Cognition Cognitive impairment First-episode psychosis MATRICS consensus cognitive battery Low-income country Uganda Neuropsychological assessment |
| title | Prevalence, profile and associations of cognitive impairment in Ugandan first-episode psychosis patients |
| title_full | Prevalence, profile and associations of cognitive impairment in Ugandan first-episode psychosis patients |
| title_fullStr | Prevalence, profile and associations of cognitive impairment in Ugandan first-episode psychosis patients |
| title_full_unstemmed | Prevalence, profile and associations of cognitive impairment in Ugandan first-episode psychosis patients |
| title_short | Prevalence, profile and associations of cognitive impairment in Ugandan first-episode psychosis patients |
| title_sort | prevalence profile and associations of cognitive impairment in ugandan first episode psychosis patients |
| topic | Cognitive impairment First-episode psychosis MATRICS consensus cognitive battery Low-income country Uganda Neuropsychological assessment |
| url | http://www.sciencedirect.com/science/article/pii/S221500132100041X |
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