Is cognitive performance associated with anxiety and depression in first-episode psychosis?

Background: In first-episode psychosis (FEP), symptoms of anxiety and depression are common. We examined whether cognitive performance is associated with these clinical measures in FEP during a one-year follow-up. Methods: Young adults with non-affective FEP (n = 52) were assessed two months after their first psychiatric contact for psychosis. Matched controls (n = 62) were administered a baseline assessment 32 FEP subjects and 44 controls were assessed again at a one-year follow-up. In both assessments, a broad neuropsychological test battery was administered. Clinical evaluation was done with the Brief Psychiatric Rating Scale. Cross-sectional correlations were calculated at both time points. Cognitive test scores were used as independent variables in regression models, predicting both baseline and follow-up symptom levels. Results: At baseline, better performance especially in verbal memory and executive functioning was associated with elevated anxiety symptoms in FEP. In addition, better performance especially in verbal working memory was associated with depression. A year later, better cognitive performance was no longer associated with affective symptoms. Limitations: Small sample sizes are a limitation. Conclusions: In the FEP group, higher cognitive performance associated with affective symptoms. Right after getting severely ill, anxiety and depression may be a part of normal adaptive reactions to the situation and markers of an intact cognitive performance. This association seems to cease during the year following the FEP.