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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV1217

Cognitive function and depressive symptoms in first-episode psychosis

COGNITIVE FUNCTION AND DEPRESSIVE SYMPTOMS IN FIRST-EPISODE PSYCHOSIS

Cognitive impairment is very common in first-episode psychosis, and global cognition is not associated with depressive symptom severity; however, the association between depressive symptoms and suicidal ideation appears stronger in patients with better-preserved cognition.

The study aimed to examine the relationship between cognitive function and depressive symptoms in first-episode psychosis (FEP) and to investigate whether cognition moderates the association between depressive symptoms and suicidal ideation. This single-center, cross-sectional study, conducted at Razi Hospital in Tunisia, included 40 patients with FEP whose symptoms had lasted less than 6 months, who were partially clinically stabilized, and who were assessed at their first outpatient follow-up visit (mean age 26.3 ± 5.9 years; 70.0% male; 67.5% with substance use; 22.5% with a history of suicide attempts). The Montreal Cognitive Assessment (MoCA), Calgary Depression Scale for Schizophrenia (CDSS), PANSS, Birchwood Insight Scale, and Columbia–Suicide Severity Rating Scale (C-SSRS) were administered by a single assessor; Pearson and Spearman correlations and exploratory binary logistic regression were used. The mean MoCA score was 18.90 ± 4.31 (range 10 to 29), with 97.5% of participants (39/40) scoring below the conventional cutoff of 26; the mean CDSS score was 5.63 ± 5.84 (range 0 to 18), and 32.5% of patients (13/40) had clinically significant depressive symptoms (CDSS score of 7 or higher). No association was found between global cognitive performance and depressive symptom severity (Pearson r = 0.082, p = 0.615; Spearman rho = 0.090, p = 0.580). In the logistic regression predicting the presence of suicidal ideation from CDSS scores, the effect became stronger as MoCA scores increased: at a low MoCA score (14.6), OR 1.07 [95% CI 0.87 to 1.32], p = 0.531; at a moderate MoCA score (18.9), OR 1.29 [1.07 to 1.55], p = 0.009; and at a high MoCA score (23.2), OR 1.54 [1.09 to 2.19], p = 0.015 (McFadden R² = 0.309; likelihood ratio p = 0.001). Because the CDSS-by-MoCA interaction term did not reach statistical significance (p = 0.105), the authors present this pattern as hypothesis-generating only. In conclusion, cognitive difficulties are already detectable during the first psychotic episode, global cognition does not explain depressive symptom severity, and vigilance in suicide risk assessment should not be reduced in patients whose cognition appears preserved.

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