Neuropsychological course in the prodrome and first episode of psychosis: findings from the PRIME North America Double Blind Treatment Study.

Journal Article (Journal Article)

OBJECTIVE: There is uncertainty regarding the onset timing of the cognitive deficiencies of schizophrenia. We investigated whether conversion to psychosis and/or olanzapine altered the neuropsychological course of subjects within the first-ever double blind medication study of the putative schizophrenia first episode prodrome. METHOD: Sixty participants in a double blind trial of olanzapine as a treatment for putative prodromal states were assessed at entry (pre-randomization), and again at 6 and 12 months (if they remained non-psychotic), or at any of these points prior to psychosis followed by post-psychosis and 6 months post-psychosis assessments. RESULTS: Participants who converted to psychosis did not differ from placebo non-converters in pre-randomization global neuropsychological status. Early converters did not differ from later converters in entry neuropsychological status. Subjects who converted after 6 months did not show neuropsychological declines during the initial, pre-psychosis, 6 months. Neuropsychological course did not differ between converters to psychosis and non-converters, or between olanzapine and placebo-assigned subjects. CONCLUSIONS: Neither the onset of frank psychosis nor olanzapine treatment of the prodrome significantly alters neuropsychological course in persons considered to be at high risk at their initial (pre-psychosis) assessment. These findings suggest that the neuropsychological deficiencies associated with psychotic conditions largely pre-exist the first frank psychotic episode.

Full Text

Duke Authors

Cited Authors

  • Hawkins, KA; Keefe, RSE; Christensen, BK; Addington, J; Woods, SW; Callahan, J; Zipursky, RB; Perkins, DO; Tohen, M; Breier, A; McGlashan, TH

Published Date

  • October 2008

Published In

Volume / Issue

  • 105 / 1-3

Start / End Page

  • 1 - 9

PubMed ID

  • 18774696

International Standard Serial Number (ISSN)

  • 0920-9964

Digital Object Identifier (DOI)

  • 10.1016/j.schres.2008.07.008


  • eng

Conference Location

  • Netherlands