Cognitive alterations in groups at risk for psychosis: neutral markers of genetic risk or indicators of social disability?

Abstract

Some cognitive impairments serve as neutral endophenotypic marker across the psychosis continuum. However, other cognitive alterations associated with transmission of psychosis may have a direct impact on the pathway from risk to psychopathology and alterations in functioning.

The association between psychotic experiences and disability: results from the WHO World Mental Health Surveys

“…A large cross-national study also reported a relationship between the PEs and general health status derived from 16 health-related domains (17). There is robust evidence that individuals with psychotic disorders experience disability across a range of domains (13, 14, 18, 19), with recent evidence from a meta-analyses indicating that those at high risk of psychosis also suffer from disability (20, 21). Based on these findings, and if psychosis can be considered to occur on a continuum (22), it is reasonable to hypothesize that individuals with PEs but without a psychotic disorder per se are also more likely to have disability (compared to those without PEs).…”

Cognitive alterations in patients with non‐affective psychotic disorder and their unaffected siblings and parents

“…Subtle cognitive deficits are present before psychosis onset and may help to predict conversion to psychosis in Ôclinical high-riskÕ subjects who are in the putative prodromal phase of psychosis (2,3). Cognitive alterations may therefore reflect the expression of genetic vulnerability to schizophrenia (4)(5)(6)(7). Cognitive alterations may therefore reflect the expression of genetic vulnerability to schizophrenia (4)(5)(6)(7).…”

“…Attenuated cognitive alterations have also been reported in clinically unaffected relatives of schizophrenia patients; these relatives are referred to as being at Ôgenetic high riskÕ for psychosis. Cognitive alterations may therefore reflect the expression of genetic vulnerability to schizophrenia (4)(5)(6)(7). Identifying such cognitive intermediate phenotypes may be a productive approach in genetic linkage and association studies in schizophrenia, as they are closer to the mechanism for gene action than the overall disease phenotype.…”

Behavior regulation and mood predict social functioning among healthy young adults

“…The executive system has been argued to encompass impulse control and other influences on behavior regulation (Roth, Isquith, & Gioia, 2005). Among adults with schizophrenia, for example, executive dysfunction is related to poorer overall health and quality of life (Williams et al, 2008) and general difficulty functioning within the community (Green, 1996;Jabben, van Os, Janssen, Versmissen, & Krabbendam, 2007). Executive dysfunction is also common among other clinical populations that, by definition, exhibit impaired social functioning, such as individuals referred for anger management treatment (VillemarettePittman, 2004) and adult males with antisocial personality disorder (Dolan & Park, 2002).…”