Individuals with first episode psychosis (FEP) exhibit cognitive impairment across all domains before receiving antipsychotic treatment, as shown in a systematic review and meta-analysis. This emphasizes the importance of identifying patients with severe cognitive challenges who may benefit from cognitive remediation. Cognitive deficits were observed in FEP patients compared to healthy controls, with the largest impairments in processing speed and verbal learning. Antipsychotic drug-naive FEP patients also showed higher variability in cognitive performance. The study highlights the importance of cognitive assessments to predict functional outcomes and guide cognitive remediation. The main limitation was potential confounders in testing unmedicated individuals with psychosis.
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