Cognitive Decline and Disrupted Cognitive Trajectory in Schizophrenia

Keefe, Richard S.E.; Kahn, René S.

doi:10.1001/jamapsychiatry.2017.0312

Cited by 19 publications

(15 citation statements)

References 8 publications

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“…Worsening cognitive function over time may be a prime factor in eventual, if not incipient, psychosis. 33 , 36 , 66 , 67 …”

Section: Discussionmentioning

confidence: 99%

“… 27 Equivocal evidence ranges from modest improvements in cognition in converters and first episode psychosis 26 to suggestions that cognitive decline may be a strong factor in eventual psychosis. 33 , 35 , 36 Previous reports indicate that approximately 50% of individuals at UHR for psychosis improve spontaneously within a short follow-up time frame. 37 …”

Section: Introductionmentioning

confidence: 99%

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Longitudinal Cognitive Changes in Young Individuals at Ultrahigh Risk for Psychosis

et al. 2018

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Key PointsQuestionDo baseline and longitudinal cognitive architecture discriminate healthy controls from subgroups of young individuals at risk for psychosis?FindingsThis multiple-group design study involving 384 healthy controls and 173 individuals at ultrahigh risk for psychosis found that baseline cognitive architecture differentiated healthy controls from converters and nonremitters. Remitters were found to recover their cognitive deficits over time, but nonremitters did not.MeaningCognitive deficits appear to identify the individuals most likely to develop psychosis and appear to reflect an underlying deterioration of a person’s clinical condition over time.

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“…Worsening cognitive function over time may be a prime factor in eventual, if not incipient, psychosis. 33 , 36 , 66 , 67 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Longitudinal Cognitive Changes in Young Individuals at Ultrahigh Risk for Psychosis

et al. 2018

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“…Low scores could also have been the result of cognitive decline caused by having a chronic severe mental illness and/or a long history of alcohol and drug use. In about half of the patients with schizophrenia, for instance, a decline in cognitive functioning was found when compared to their earlier educational level (Keefe & Kahn, ). One should keep in mind that the scores on the SCIL (as well as results on other tests) may be influenced by having a psychiatric disorder, the severity of current psychiatric symptoms, substance use or use of psychotropic medication, as well as the motivation of the tested person to perform well on the test.…”

Section: Discussionmentioning

confidence: 99%

Screening for intellectual disabilities and borderline intelligence in Dutch outpatients with severe mental illness

Lang

Smits

Penterman

et al. 2019

Research Intellect Disabil

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Background The reliability and validity of the Screener for Intelligence and Learning Disabilities (SCIL) are unknown in a population of outpatients with severe mental illness. The prevalence of mild or borderline intellectual disabilities (MBID); an umbrella term for people with borderline intellectual functioning (BIF) and mild intellectual disability (MID) in this population is also unknown. Methods A total of 625 patients were screened with the SCIL, 201 of which also had IQ test results. Results Cronbach’s alpha of the SCIL was 0.73. The AUC value for detecting MBID was 0.81, and also 0.81 for detecting MID, with percentages of correctly classified subjects (when using the advised cut‐off scores) being 73% and 79%, respectively. The SCIL results suggested that 40% of the patients were suspected of MBID and 20% of MID. Conclusion The SCIL seems to be an appropriate screening tool for MBID. It is important to screen for MBID because a substantial proportion of outpatients with severe mental illness appear to be functioning at this level. It is necessary to adapt treatment for these patients.

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“…There have also been studies that identified correlations between structural features and antipsychotic treatment response from the perspectives of both volume and morphology, involving asymmetry and hypogyria (Altamura et al, 2017;Dusi et al, 2017;Francis et al, 2018;Fung et al, 2014;Hutcheson, Clark, Bolding, White, & Lahti, 2014;Molina, Taboada, Aragues, Hernandez, & Sanz-Fuentenebro, 2014;Morch-Johnsen et al, 2015;Palaniyappan et al, 2013;Premkumar et al, 2015). However, functional brain imaging-based prognostic markers require further investigation before being used clinically for individualized psychosis treatment decisions (Keefe & Kahn, 2017).…”

Section: Introductionmentioning

confidence: 99%

Prediction of early response to overall treatment for schizophrenia: A functional magnetic resonance imaging study

et al. 2019

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Introduction Treatment response at an early stage of schizophrenia is of considerable value with regard to future management of the disorder; however, there are currently no biomarkers that can inform physicians about the likelihood of response. Objects We aim to develop and validate regional brain activity derived from functional magnetic resonance imaging (fMRI) as a potential signature to predict early treatment response in schizophrenia. Methods Amplitude of low‐frequency fluctuation (ALFF) was measured at the start of the first/single episode resulting in hospitalization. Inpatients were included in a principal dataset ( n = 79) and a replication dataset ( n = 44). Two groups of healthy controls ( n = 87; n = 106) were also recruited for each dataset. The clinical response was assessed at discharge from the hospital. The predictive capacity of normalized ALFF in patients by healthy controls, ALFF ratio , was evaluated based on diagnostic tests and clinical correlates. Results In the principal dataset, responders exhibited increased baseline ALFF in the left postcentral gyrus/inferior parietal lobule relative to non‐responders. ALFF ratio of responders before treatment was significantly higher than that of non‐responders ( p < 0.001). The area under the receiver operating characteristic curve was 0.746 for baseline ALFF ratio to distinguish responders from non‐responders, and the sensitivity, specificity, and accuracy were 72.7%, 68.6%, and 70.9%, respectively. Similar results were found in the independent replication dataset. Conclusions Baseline regional activity of the brain seems to be predictive of early response to treatment for schizophrenia. This study shows that psycho‐neuroimaging holds promise for influencing the clinical treatment and management of schizophrenia.

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Cognitive Decline and Disrupted Cognitive Trajectory in Schizophrenia

Cited by 19 publications

References 8 publications

Longitudinal Cognitive Changes in Young Individuals at Ultrahigh Risk for Psychosis

Longitudinal Cognitive Changes in Young Individuals at Ultrahigh Risk for Psychosis

Screening for intellectual disabilities and borderline intelligence in Dutch outpatients with severe mental illness

Prediction of early response to overall treatment for schizophrenia: A functional magnetic resonance imaging study

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