Assessing Cognitive Reserve Outcomes and Biomarkers in First Episode of Psychosis: Rationale, Objectives, Protocol and Preliminary Results of the CRASH Project

Introduction: Cognitive reserve (CR) has proved to predict clinical, cognitive and functional outcomes. Despite this, it is necessary to shed greater light on the identification of factors associated with CR in first psychotic episodes (FEP). The aim of this article was to describe the rationale, objectives, protocol, and preliminary results for a new project of CR. Material and methods: The CRASH Project is a coordinated, multicenter and multimodal study of patients with a FEP with a one-year prospective longitudinal follow-up. This project is funded by the Departament de Salut of the Generalitat de Catalunya and file code SLT006/17/00345. The project was structured in four modules, each focusing on a different outcome measure: (1) General and Basic; (2) Neuroimaging; (3) Neurocognition; and (4) Biological. Results: A total of 90 FEP patients and 100 healthy controls were enrolled in this study. There were no differences between patients and HC in terms of age (p = 0.104), gender (p = 0.140) and socioeconomic status (p = 0.104). However, at inclusion, we found significant differences in functioning (p < 0.001), CR (p < 0.001), and all cognitive domains except executive functioning. Patients were clinically stable at inclusion. Conclusions: The results obtained by this project are hoped to contribute as much towards the understanding of the illness' physiopathology as towards the generation of new treatment designs and therapeutic strategies that allow for a personalized management according to each individual's profile, which includes CR as well as clinical characteristics.