4.7 Article

Effects of socioeconomic status in cognition of people with schizophrenia: results from a Latin American collaboration network with 1175 subjects

Journal

PSYCHOLOGICAL MEDICINE
Volume 52, Issue 11, Pages 2177-2188

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291721002403

Keywords

Cognition; low- and middle-income countries; schizophrenia; social factors

Funding

  1. ARGENTINA - Agencia de Promocion [PICT-2014-0633]
  2. BRAZIL - Fundacao de Amparo a Pesquisa do Estado de Sao Paulo [Fapesp 2010/10788-6]
  3. CHILE - Agencia Nacional de Investigacion y Desarrollo (ANID) Anillo [ACT1414, ACT192064]
  4. FONDECYT [1180358, 1200601, 3190790]
  5. XII Concurso Nacional de Proyectos de Investigacion y Desarrollo en Salud, FONIS 2015
  6. Proyecto , Ministerio de Economia, Chile [SA15I20058]
  7. Biomedical Neuroscience Institute [ICM P09-015F]
  8. ANID FONDECYT [11150846]
  9. ANID - Millennium Science Initiative
  10. COLOMBIA - PRISMA UNION TEMPORAL (UNIVERSIDAD DE ANTIOQUIA / HOSPITAL SAN VICENTE FUNDACION)
  11. Colciencias-INVITACION [99059634]
  12. MEXICO - Instituto Nacional de Neurologia y Neurocirugia: Consejo Nacional de Ciencia y Tecnologia, Mexico, (CONACyT) [261987, 261895]
  13. National Institutes of Health [R21 MH102374]
  14. CONACyT

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This study aims to investigate the cognitive performance of Latin American individuals with schizophrenia in relation to clinical factors and socioeconomic status, highlighting the impact of demographic and socioeconomic factors on cognitive capacity in individuals with psychosis in low- and middle-income countries. Results showed that patients had worse cognitive performance compared to controls, with age and diagnosis being independent predictors, and socioeconomic factors playing a more significant role in patients' cognition than in controls.
Background Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls. Methods We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments. Results Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology. Conclusions Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.

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