Cognitive functioning and ethnicity in first episode psychosis

Background: The risk for psychosis is increased for ethnic minorities. Much less is known about ethnic differences in cognitive deficits and their relationship with course and functional outcome. Goal: Explore relationships between ethnicity, cognitive deficits and outcome measures at baseline and 6 months follow up in a multi-ethnic sample of first episode psychosis patients. Method: Cases: All patients who made first-contact during a 1-year period and completed psychological assessment at baseline. Estimates ofinclusions per November 01, 2010: Baseline: n = 140; Follow up: n = 45. Instruments: 15 different neuropsychological instruments are used to assess seven cognitive domains: Memory, Attention, Speed of Processing, Reasoning, Verbal learning, Visual learning and Social Cognition. Outcome measures: Global Assessment of Functioning scale (GAF), Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance scale (PSP). Statistical analysis: Cases are grouped per ethnicity. Differences between groups are tested with independent sample T-tests, ANOVA, regression analyses and multi-level analyses. Covariates: Level of education, gender and age. Results: Preliminary analyses of baseline measures showed significant differences between ethnic minority patients and Dutch patients on all seven domains. Ethnic minority patients had lower scores, especially in the domains of Attention, Visual Learning, Speed of Processing and Social Cognition. Follow-up data on course and functional outcome will be presented. Conclusion: Marked differences are apparent between Dutch and ethnic minority patients at baseline on all seven cognitive domains. Potential explanations include cross-cultural bias in measurements and more severe psychopathology in the ethnic minority subgroup.