Longitudinal Motor Trajectories and 2-Year Cognitive and Functional Outcomes in First-Episode Psychosis.

BACKGROUND AND HYPOTHESIS: Motor abnormalities (MAs) are intrinsic features of the psychosis spectrum, but their longitudinal associations with cognition and functioning remain unclear. We hypothesized that Positive and Negative Syndrome Scale (PANSS)-derived hypokinetic and hyperkinetic motor dimensions would be associated with cognitive and functional outcomes and that distinct longitudinal motor trajectories would capture clinically relevant heterogeneity in first-episode psychosis (FEP).

STUDY

DESIGN

In a multicenter naturalistic FEP cohort, 159 patients completed clinical, functional, and neurocognitive assessments at 2 months and 2 years. PANSS-derived motor dimensions were assessed longitudinally. Cross-sectional and longitudinal associations with cognition and functioning were examined using correlational, mixed-effects, and trajectory-based analyses, including growth mixture modeling.

STUDY

RESULTS

At 2 months, hypokinetic severity was associated with poorer verbal memory (r = -0.252, p = .002), whereas hyperkinetic severity was associated with poorer vocabulary (r = -0.260, p = .001) and verbal memory (r = -0.237, P = .003). Prospectively, higher 2-month hyperkinetic severity was associated with poorer vocabulary (r = -0.282, P < .001), verbal memory (r = -0.366, P < .001), and global cognition (r = -0.309, P = .001) at 2 years. Mixed-effects analyses confirmed associations between hyperkinetic severity and poorer longitudinal verbal memory trajectory (β = -0.295, P = .019). Higher-severity hyperkinetic trajectories remained associated with poorer 2-year verbal memory (β = -0.858, P = .003) and functional outcome (β = 10.209, P = .005).

CONCLUSIONS

PANSS-derived motor dimensions capture meaningful longitudinal heterogeneity in FEP. Sustained hyperkinetic severity was consistently associated with poorer verbal memory and functional outcome over time, supporting the relevance of MAs as longitudinal correlates of cognitive and functional variability in early psychosis.