Cognitive function in long term psychosis patients in a tertiary care hospital

Introduction Psychosis refers to symptoms that are positive, disorganised,or negative and affects 3% of the population yet little information on long-term cognition is available. Objectives To determine association between symptom severity,duration of disease and cognitive impairment. Methods 50 adult patients suffering from psychosis(DSM-5) for minimum 1 year and currently on at least 1 antipsychotic drug whose cognition and severity of symptoms were assessed by Montreal Cognitive Assessment test(MoCA) and Positive and Negative Syndrome Scale (PANSS) respectively were included in this cross sectional,cohort study. Results Mean age of population was 41.5±12.33 years.Disorganised behaviour and speech were the prevalent core symptoms and risperidone was the choice of drug. Table 1 MALE FEMALE P value T-test Overall mean Total PANSS Score 68.2 ± 27.5 75.2 ± 34.9 0.430 71.1 ± 30.7 Positive PANSS 15.3 ± 7.67 17.4 ± 7.59 0.357 16.2 ± 7.63 Negative PANSS 17.2 ± 7.06 18.3 ± 8.92 0.646 17.7 ± 7.83 Generalised PANSS 35.6 ± 14.7 39.5 ± 20.6 0.434 37.2 ± 17.3 Table 2 MALE (58%,n=29) FEMALE(42%,n=21) OVERALL(n=50) Mild cognitive impairment(CI) 34%(17) 14%(7) 48%(24) Moderate CI 24%(12) 20%(10) 44%(22) Severe CI 0% 8%(4) 8%(4) Symptom severity was mild and more negative symptoms were prominent (composite score: -1.48±6.47) (Table 1 PANSS Score) and an overall moderate cognitive impairment(16.5±4.46, table 2) was seen in population. Females showed a significantly lower MoCA score as compared to males (14.9±4.8 vs 17.65 ± 3.78, p=0.03) implying more cognitive decline (image 3).There is a strong, negative, linear correlation between MoCA and PANSS scores (r= -0.688, p<0.001) wherein all domains(image 1)except memory were negatively correlated to PANSS. Duration of illness showed a moderate, positive,linear and weak, negative, linear correlation with PANSS( r= 0.417, p =0.003) and MoCA(r = -0.314, p= 0.026) respectively. PANSS items were negatively correlated to MoCA in positive, negative and generalised items except delusions, blunted effect and tension(image 2). Image 1: Image 2: Image 3: Conclusions We conclude that cognitive function significantly declines( executive function was the most and memory was not significantly impacted) with respect to increasing disease severity and duration of illness in long term psychosis.Most positive symptoms, excluding delusions,and negative symptoms (apart from blunted affect) and general symptoms (except tension), were significantly linked to cognitive decline. Disclosure of Interest None Declared