Browsing by Author "Mäkipelto, Ville"

Aims: Schizophrenia is characterized by cognitive impairment that associates with many problems in everyday life and functioning. Earlier research has hypothesized that antidepressant medication may associate with better cognitive functioning among schizophrenia patients, but empirical results are mixed. This study explored the profile of schizophrenia patients that use antidepressants and asked whether there is an association between antidepressant use and cognitive performance in a clinical patient sample. Because of effects on the central nervous system, benzodiazepines and anticholinergic medications were also considered. Methods: Study participants were drawn from the SUPER-Finland cohort, which was collected among patients with psychotic illnesses in 2016–2018 from all university hospital districts across Finland (n=10474). The analysis included working-age (18–70) patients with a schizophrenia diagnosis (F20) and complete results from the brief cognitive assessment (n=3411). Information about regular medications and psychosocial factors were gathered through questionnaire and interview. Cognition was assessed with CANTAB (Cambridge Neuropsychological Test Automated Battery), out of which the subtests measuring reaction time (RTI) and visual learning (PAL) were included. The association of antidepressants on cognition was examined using both pooled antidepressants and various antidepressant groups as predictors in linear regression models. Gender, age, age of diagnosis, living status, relationship, education, and psychological distress were controlled in the models. Results: Over 35% of schizophrenia patients regularly used at least one antidepressant. On average, schizophrenia patients using antidepressants experienced lower well-being and more psychological distress than patients without antidepressants. The use of antidepressants was not generally associated with better or poorer cognitive performance. However, the use of SNRI antidepressants was associated with a significantly faster reaction time. The use of benzodiazepines was associated with poorer cognitive performance in both reaction time and visual learning. Conclusions: The results support the conclusion that there is generally no meaningful association between antidepressants and better cognitive performance in schizophrenia. However, the association of SNRI-medicines with a slightly faster reaction time is promising and warrants further research. Several psychosocial factors were associated with the cognitive performance of schizophrenia patients, which underlines the need for supporting psychosocial well-being in cognitive rehabilitation.