{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T22:10:59Z","timestamp":1793398259105,"version":"4.5.0"},"reference-count":42,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2024,5,1]]},"abstract":"\n Importance<\/jats:title>\n Cognitive impairment contributes significantly to clinical outcome and level of function in individuals with psychotic disorders. These impairments are present already at psychosis onset at a group level; however, the question of heterogeneity in cognitive function among patients has not been systematically investigated.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To provide an updated quantification of cognitive impairment at psychosis onset before patients receive potentially confounding antipsychotic treatment, and to investigate variability in cognitive function compared with healthy controls.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n In this systematic review and meta-analysis, PubMed articles were searched up to September 15, 2022.<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n Original studies reporting data on cognitive function in antipsychotic drug\u2013naive patients with first-episode psychosis (FEP) were included.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n Data were independently extracted by 2 researchers. Cognitive tasks were clustered according to 6 domains of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery and the domain of executive function. Random-effects model meta-analyses of mean differences and coefficient of variation ratios (CVRs) were performed, as well as meta-regressions, assessment of study quality, and publication bias.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n The main outcome measure was Hedges\n g<\/jats:italic>\n for mean differences in cognition and CVR for within-group variability.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Fifty studies were included in the analysis with a total of 2625 individuals with FEP (mean [SD] age, 25.2 [3.6] years, 60% male; 40% female) and 2917 healthy controls (mean [SD] age, 26.0 [4.6]; 55% male; 45% female). In all cognitive domains, the FEP group displayed significant impairment compared with controls (speed of processing: Hedges\n g<\/jats:italic>\n \u2009=\u2009\u22121.16; 95% CI, \u22121.35 to \u22120.98; verbal learning: Hedges\n g<\/jats:italic>\n \u2009=\u2009\u22121.08; 95% CI, \u22121.28 to \u22120.88; visual learning: Hedges\n g<\/jats:italic>\n \u2009=\u2009\u22121.05; 95% CI, \u22121.27 to \u22120.82; working memory: Hedges\n g<\/jats:italic>\n \u2009=\u2009\u22121.04; 95% CI, \u22121.35 to \u22120.73; attention: Hedges\n g<\/jats:italic>\n \u2009=\u2009\u22121.03; 95% CI, \u22121.24 to \u22120.82; reasoning\/problem solving: Hedges\n g<\/jats:italic>\n \u2009=\u2009\u22120.90; 95% CI, \u22121.12 to \u22120.68; executive function: Hedges\n g<\/jats:italic>\n \u2009=\u2009\u22120.88; 95% CI, \u22121.07 to \u22120.69). Individuals with FEP also exhibited a larger variability across all domains (CVR range, 1.34-1.92).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n Results of this systematic review and meta-analysis identified cognitive impairment in FEP before the initiation of antipsychotic treatment, with large effect sizes. The high variability within the FEP group suggests the need to identify those individuals with more severe cognitive problems who risk worse outcomes and could benefit the most from cognitive remediation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2024.0016","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T11:35:22Z","timestamp":1709120122000},"page":"468","source":"Crossref","is-referenced-by-count":83,"title":["Cognitive Function and Variability in Antipsychotic Drug\u2013Naive Patients With First-Episode Psychosis"],"prefix":"10.1001","volume":"81","author":[{"given":"Maria","family":"Lee","sequence":"first","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Cernvall","sequence":"additional","affiliation":[{"name":"Department of Medical sciences, Psychiatry, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Borg","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Sweden"},{"name":"Center for Cognitive and Computational Neuropsychiatry, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pontus","family":"Plav\u00e9n-Sigray","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Sweden"},{"name":"Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Larsson","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Erhardt","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl M.","family":"Sellgren","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Sweden"},{"name":"Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Fatouros-Bergman","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Cervenka","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Sweden"},{"name":"Department of Medical sciences, Psychiatry, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"3","key":"yoi240001r1","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1037\/0894-4105.12.3.426","article-title":"Neurocognitive deficit in schizophrenia: a quantitative review of the evidence.","volume":"12","author":"Heinrichs","year":"1998","journal-title":"Neuropsychology"},{"issue":"5","key":"yoi240001r2","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1001\/archpsyc.64.5.532","article-title":"Overlooking the obvious: a meta-analytic comparison of digit symbol coding tasks and other cognitive measures in schizophrenia.","volume":"64","author":"Dickinson","year":"2007","journal-title":"Arch Gen Psychiatry"},{"issue":"1","key":"yoi240001r3","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.schres.2013.07.009","article-title":"The global cognitive impairment in schizophrenia: consistent over decades and around the world.","volume":"150","author":"Schaefer","year":"2013","journal-title":"Schizophr Res"},{"issue":"3","key":"yoi240001r4","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1176\/ajp.153.3.321","article-title":"What are the functional consequences of neurocognitive deficits in schizophrenia?","volume":"153","author":"Green","year":"1996","journal-title":"Am J Psychiatry"},{"issue":"1","key":"yoi240001r5","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1177\/070674371405900103","article-title":"Neurocognition: clinical and functional outcomes in schizophrenia.","volume":"59","author":"Lepage","year":"2014","journal-title":"Can J Psychiatry"},{"issue":"July","key":"yoi240001r6","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1016\/j.neubiorev.2019.07.020","article-title":"Pathways to functional outcomes in schizophrenia spectrum disorders: meta-analysis of social cognitive and neurocognitive predictors.","volume":"105","author":"Halverson","year":"2019","journal-title":"Neurosci Biobehav Rev"},{"issue":"6","key":"yoi240001r7","doi-asserted-by":"publisher","first-page":"2317","DOI":"10.1017\/S0033291721004153","article-title":"Longitudinal clinical and functional outcome in distinct cognitive subgroups of first-episode psychosis: a cluster analysis.","volume":"53","author":"Oomen","year":"2023","journal-title":"Psychol Med"},{"issue":"2","key":"yoi240001r8","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1093\/oxfordjournals.schbul.a033460","article-title":"Childhood cognitive functioning in schizophrenia patients and their unaffected siblings: a prospective cohort study.","volume":"26","author":"Cannon","year":"2000","journal-title":"Schizophr Bull"},{"issue":"3","key":"yoi240001r9","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1001\/2013.jamapsychiatry.43","article-title":"Decline in cognitive performance between ages 13 and 18 years and the risk for psychosis in adulthood: a Swedish longitudinal cohort study in males.","volume":"70","author":"MacCabe","year":"2013","journal-title":"JAMA Psychiatry"},{"issue":"7","key":"yoi240001r10","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1001\/jamapsychiatry.2022.1142","article-title":"The course of general cognitive ability in individuals with psychotic disorders.","volume":"79","author":"Jonas","year":"2022","journal-title":"JAMA Psychiatry"},{"issue":"1-3","key":"yoi240001r11","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/j.schres.2014.06.034","article-title":"Meta-analysis of cognitive performance in drug-na\u00efve patients with schizophrenia.","volume":"158","author":"Fatouros-Bergman","year":"2014","journal-title":"Schizophr Res"},{"issue":"3","key":"yoi240001r12","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1037\/a0014708","article-title":"Neurocognition in first-episode schizophrenia: a meta-analytic review.","volume":"23","author":"Mesholam-Gately","year":"2009","journal-title":"Neuropsychology"},{"issue":"3","key":"yoi240001r13","doi-asserted-by":"publisher","DOI":"10.1136\/gpsych-2018-100043","article-title":"Meta-analysis of cognitive function in Chinese first-episode schizophrenia: MATRICS Consensus Cognitive Battery (MCCB) profile of impairment.","volume":"32","author":"Zhang","year":"2019","journal-title":"Gen Psychiatr"},{"issue":"2","key":"yoi240001r14","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1176\/appi.ajp.2007.07010042","article-title":"The MATRICS Consensus Cognitive Battery, part 1: test selection, reliability, and validity.","volume":"165","author":"Nuechterlein","year":"2008","journal-title":"Am J Psychiatry"},{"issue":"1-3","key":"yoi240001r15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.schres.2009.03.005","article-title":"Schizophrenia, \u201cjust the facts\u201d 4. clinical features and conceptualization.","volume":"110","author":"Tandon","year":"2009","journal-title":"Schizophr Res"},{"issue":"4","key":"yoi240001r16","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1007\/s11065-019-09422-7","article-title":"A systematic review of studies reporting data-driven cognitive subtypes across the psychosis spectrum.","volume":"30","author":"Green","year":"2020","journal-title":"Neuropsychol Rev"},{"issue":"August","key":"yoi240001r17","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1016\/j.neubiorev.2019.09.006","article-title":"Characterising the structure of cognitive heterogeneity in schizophrenia spectrum disorders: a systematic review and narrative synthesis.","volume":"107","author":"Carruthers","year":"2019","journal-title":"Neurosci Biobehav Rev"},{"issue":"2","key":"yoi240001r18","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1111\/mee3.2015.6.issue-2","article-title":"Meta-analysis of variation: ecological and evolutionary applications and beyond.","volume":"6","author":"Nakagawa","year":"2015","journal-title":"Methods Ecol Evol"},{"issue":"1","key":"yoi240001r19","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1038\/s41398-022-01961-7","article-title":"Examining the variability of neurocognitive functioning in individuals at clinical high risk for psychosis: a meta-analysis.","volume":"12","author":"Catalan","year":"2022","journal-title":"Transl Psychiatry"},{"issue":"9","key":"yoi240001r20","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1001\/jamapsychiatry.2021.0830","article-title":"Probability of transition to psychosis in individuals at clinical high risk: an updated meta-analysis.","volume":"78","author":"Salazar de Pablo","year":"2021","journal-title":"JAMA Psychiatry"},{"key":"yoi240001r21","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"issue":"8","key":"yoi240001r22","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1001\/jamasurg.2021.0522","article-title":"MOOSE reporting guidelines for meta-analyses of observational studies.","volume":"156","author":"Brooke","year":"2021","journal-title":"JAMA Surg"},{"issue":"1","key":"yoi240001r23","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan-a web and mobile app for systematic reviews.","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst Rev"},{"issue":"5","key":"yoi240001r24","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1038\/mp.2017.25","article-title":"CSF GABA is reduced in first-episode psychosis and associates to symptom severity.","volume":"23","author":"Orhan","year":"2018","journal-title":"Mol Psychiatry"},{"issue":"1","key":"yoi240001r25","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1038\/s41537-021-00176-x","article-title":"No association between cortical dopamine D2 receptor availability and cognition in antipsychotic-naive first-episode psychosis.","volume":"7","author":"Lee","year":"2021","journal-title":"NPJ Schizophr"},{"key":"yoi240001r26","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.cpr.2016.10.001","article-title":"Deficits in social cognition in first episode psychosis: a review of the literature.","volume":"50","author":"Healey","year":"2016","journal-title":"Clin Psychol Rev"},{"issue":"3","key":"yoi240001r28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v036.i03","article-title":"Conducting meta-analyses in R with the metafor package.","volume":"36","author":"Viechtbauer","year":"2010","journal-title":"J Stat Softw"},{"issue":"7321","key":"yoi240001r33","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1038\/nature09552","article-title":"Rethinking schizophrenia.","volume":"468","author":"Insel","year":"2010","journal-title":"Nature"},{"issue":"4","key":"yoi240001r34","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1176\/appi.ajp.2020.20020132","article-title":"Genetically, developmentally, and clinically distinct cognitive subtypes in schizophrenia: a tale of three trajectories.","volume":"177","author":"Lewandowski","year":"2020","journal-title":"Am J Psychiatry"},{"issue":"5","key":"yoi240001r35","doi-asserted-by":"publisher","first-page":"1902","DOI":"10.1038\/s41380-023-01949-9","article-title":"Cognitive impairment in schizophrenia: aetiology, pathophysiology, and treatment.","volume":"28","author":"McCutcheon","year":"2023","journal-title":"Mol Psychiatry"},{"issue":"8","key":"yoi240001r36","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1001\/jamapsychiatry.2021.1290","article-title":"Neurocognitive functioning in individuals at clinical high risk for psychosis: a systematic review and meta-analysis.","volume":"78","author":"Catalan","year":"2021","journal-title":"JAMA Psychiatry"},{"issue":"2","key":"yoi240001r37","first-page":"93","article-title":"The prodromal stage of psychotic illness: observation, detection, or intervention?","volume":"28","author":"Addington","year":"2003","journal-title":"J Psychiatry Neurosci"},{"issue":"5","key":"yoi240001r38","doi-asserted-by":"publisher","first-page":"587","DOI":"10.3109\/00048679609062654","article-title":"The initial prodrome in psychosis: descriptive and qualitative aspects.","volume":"30","author":"Yung","year":"1996","journal-title":"Aust N Z J Psychiatry"},{"issue":"2","key":"yoi240001r39","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1017\/S0033291703001119","article-title":"Understanding delay in treatment for first-episode psychosis.","volume":"34","author":"Norman","year":"2004","journal-title":"Psychol Med"},{"key":"yoi240001r40","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/j.schres.2020.11.031","article-title":"The case for improved transdiagnostic detection of first-episode psychosis: electronic health record cohort study.","volume":"228","author":"Fusar-Poli","year":"2021","journal-title":"Schizophr Res"},{"issue":"4","key":"yoi240001r41","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1093\/schbul\/sbab022","article-title":"A meta-analysis of cognitive remediation for schizophrenia: efficacy and the role of participant and treatment factors.","volume":"47","author":"Lejeune","year":"2021","journal-title":"Schizophr Bull"},{"issue":"5","key":"yoi240001r42","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1176\/appi.ajp.2010.10060855","article-title":"A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes.","volume":"168","author":"Wykes","year":"2011","journal-title":"Am J Psychiatry"},{"key":"yoi240001r27","doi-asserted-by":"crossref","DOI":"10.1201\/9781003107347","volume-title":"Doing Meta-Analysis With R: A Hands-On Guide","author":"Harrer","year":"2021"},{"key":"yoi240001r31","doi-asserted-by":"crossref","DOI":"10.1002\/9781119558378","volume-title":"Introduction to Meta-Analysis","author":"Borenstein","year":"2021","edition":"2nd ed"},{"key":"yoi240001r32","volume-title":"Schizophrenia: Evolution and Synthesis","author":"Kahn","year":"2013"},{"key":"yoi240001r29","unstructured":"R Core Team. R: a language and environment for statistical computing. Accessed November 10, 2023. https:\/\/www.R-project.org"},{"key":"yoi240001r30","unstructured":"Github. Meta_analysis_cogn_dnFEP. Accessed November 10, 2023. https:\/\/github.com\/MariaLeeR\/Meta_analysis_cogn_dnFEP"}],"container-title":["JAMA Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/articlepdf\/2815184\/jamapsychiatry_lee_2024_oi_240001_1713287673.48851.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T11:26:33Z","timestamp":1714562793000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/fullarticle\/2815184"}},"subtitle":["A Systematic Review and Meta-Analysis"],"short-title":[],"issued":{"date-parts":[[2024,5,1]]},"references-count":42,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamapsychiatry.2024.0016","relation":{},"ISSN":["2168-622X"],"issn-type":[{"value":"2168-622X","type":"print"}],"subject":[],"published":{"date-parts":[[2024,5,1]]}}}