The association between cognitive deficits and depressive symptoms in at-risk mental state: A comparison with first-episode psychosis

Cognitive deficits and a high prevalence of depressive symptoms have been reported in at-risk mental state (ARMS) for psychosis, but the relationships between these variables remain unclear. The Brief Assessment of Cognition in Schizophrenia (BACS) was administered to 50 individuals with ARMS, 50 with first-episode psychosis (FEP), and 30 healthy controls (HC). Clinical symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS) and the Beck Depression Inventory-2nd edition (BDI-II). Composite z-scores in BACS were compared between the three groups. Pearson correlations between composite z-scores on the BACS and indices of clinical symptoms were compared in the ARMS and FEP groups. The mean composite z-scores on the BACS for the ARMS (- 2.82) and FEP (- 2.85) groups were significantly lower than the HC group (P< 0.001); no differences between the ARMS and FEP groups emerged (P= 0.995). Cognitive deficits and depressive symptoms were significantly correlated in the ARMS group (PANSS depression: r= - 0.36, P= 0.010; BDI-II: r= - 0.34, P= 0.02), while the correlation between cognitive deficits and negative symptoms was significant in the FEP group (r= - 0.46, P= 0.001) and approached significance in the ARMS group (r= - 0.25, P= 0.08). The correlation between cognitive deficits and depressive symptoms significantly differed between the ARMS and FEP groups (PANSS depression: Z= 2.50, P= 0.012; BDI-II: Z= 1.96, P= 0.0499). Thus, a relationship between cognitive deficits and depression appears to be specific to ARMS compared to FEP.