State of illness-dependent associations of neuro-cognition and psychopathological syndromes in a large transdiagnostic cohort

Frederike Stein; Simon Schmitt; Katharina Brosch; Tina Meller; Julia-Katharina Pfarr; Kai Ringwald; Gunnar Lemmer; Alexandra Philipsen; Susanne Meinert; Hannah Lemke; Lena Waltemate; Katharina Thiel; Michael Franz; Ulrich W Preuss; Florian G Metzger; Arne Nagels; Igor Nenadić; Udo Dannlowski; Tilo Kircher; Axel Krug

doi:10.1016/j.jad.2022.12.129

State of illness-dependent associations of neuro-cognition and psychopathological syndromes in a large transdiagnostic cohort

J Affect Disord. 2023 Mar 1:324:589-599. doi: 10.1016/j.jad.2022.12.129. Epub 2022 Dec 28.

Authors

Frederike Stein¹, Simon Schmitt², Katharina Brosch², Tina Meller², Julia-Katharina Pfarr², Kai Ringwald², Gunnar Lemmer³, Alexandra Philipsen⁴, Susanne Meinert⁵, Hannah Lemke⁶, Lena Waltemate⁶, Katharina Thiel⁶, Michael Franz⁷, Ulrich W Preuss⁸, Florian G Metzger⁹, Arne Nagels¹⁰, Igor Nenadić², Udo Dannlowski⁶, Tilo Kircher², Axel Krug¹¹

Affiliations

¹ Department of Psychiatry and Psychotherapy, University of Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Germany. Electronic address: frederike.stein@staff.uni-marburg.de.
² Department of Psychiatry and Psychotherapy, University of Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Germany.
³ Institute of Psychology, University of Marburg, Germany.
⁴ Department of Psychiatry and Psychotherapy, University Hospital Bonn, Germany.
⁵ Institute for Translational Psychiatry, University of Münster, Germany; Institute for Translational Neuroscience, University of Münster, Germany.
⁶ Institute for Translational Psychiatry, University of Münster, Germany.
⁷ Psychiatric Hospital Vitos, Marburg and Gießen, Germany.
⁸ Psychiatric Hospital Vitos, Herborn, Germany.
⁹ Psychiatric Hospital Vitos, Haina, Germany; Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Germany; Geriatric Center, University Hospital of Tübingen, Germany.
¹⁰ Institute for Linguistics: General Linguistics, University of Mainz, Germany.
¹¹ Department of Psychiatry and Psychotherapy, University Hospital Bonn, Germany; Department of Psychiatry and Psychotherapy, University of Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Germany.

PMID: 36586619
DOI: 10.1016/j.jad.2022.12.129

Abstract

Background: There is a lack of knowledge regarding the relationship between dimensional psychopathological syndromes and neurocognitive functions, particularly across the major psychiatric disorders (i.e., Major Depressive Disorder (MDD), Bipolar Disorder (BD), and Schizophrenia (SZ)).

Method: SANS, SAPS, HAMA, HAM-D, and YMRS were assessed in 1064 patients meeting DSM-IV-TR criteria for MDD, BD, SZ or schizoaffective disorder (SZA). In addition, a comprehensive neuropsychological test battery was administered. Psychopathological syndromes derived from factor analysis and present state of illness were used to explore psychopathology-cognition relationships. Correlational analyses were corrected for age, sex, verbal IQ, years of education, and DSM-IV-TR diagnosis. Age of onset and total duration of hospitalizations as proxies for illness severity were tested as moderators on the cognition - psychopathology relationship.

Results: The negative syndrome, positive formal thought disorder as well as the paranoid-hallucinatory syndrome exhibited associations with neuro-cognition in an illness state-dependent manner, while the psychopathological factors depression and increased appetite only showed weak associations. Illness severity showed moderating effects on the neurocognitive-psychopathology relationship only for the negative syndrome and positive formal thought disorder.

Limitations: No healthy control subjects were entered into the analyses because of lack of variance in psychopathological symptoms, which prevents from drawing conclusions regarding the relative level of potential cognitive impairments.

Conclusions: This study suggests the relationship of neuro-cognition and psychopathology to be highly state of illness-dependent across affective and psychotic disorders. Results hint at the moderating effects of illness severity on psychopathological factors that might be more treatment resistant.

Keywords: Factor analysis; Major psychiatric disorders; Neuro-cognition; Neuropsychology; Psychopathology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Bipolar Disorder* / psychology
Cognition
Depressive Disorder, Major* / psychology
Humans
Mental Disorders* / complications
Neuropsychological Tests
Psychotic Disorders* / psychology