Cognitive Functioning in Prodromal Psychosis

Fusar‐Poli, Paolo; Deste, Giacomo; Smieskova, Renata; Barlati, Stefano; Yung, Alison R.; Howes, Oliver; Stieglitz, Rolf‐Dieter; Vita, Antonio; McGuire, Philip; Borgwardt, Stefan

doi:10.1001/archgenpsychiatry.2011.1592

Cited by 594 publications

(562 citation statements)

References 86 publications

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“…In initial cross-sectional analyses conducted in ASz and TD groups only, we observed impairments in general intelligence, verbal memory, working memory, and executive function among ASz children aged 9-12 years [39] which were less pervasive and smaller in magnitude than those characterising adults with schizophrenia [40], but similar to those observed among CHR individuals [41,42]. In subsequent analyses performed on a larger, partially overlapping sample, ASz children performed at a level intermediate to FHx children with high familial loading (C1 first-degree or C2 seconddegree relatives) and FHx children with low familial loading (one affected second-degree relative only) across a range of neurocognitive subtests [43].…”

Section: Cognitive Impairmentsupporting

confidence: 53%

Toward earlier identification and preventative intervention in schizophrenia: evidence from the London Child Health and Development Study

Laurens

Cullen

2015

Soc Psychiatry Psychiatr Epidemiol

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Purpose The London Child Health and Development Study (CHADS) is a prospective, longitudinal investigation of children, sampled from the general community aged 9-11 years and assessed biennially, who present premorbid risk markers for schizophrenia. The study aims to characterise developmental trajectories of psychological, cognitive, and biological functioning in atrisk children and identify potential targets for early preventative intervention. This review summarises CHADS findings, discusses these in the context of recent theory regarding aetiology and prevention of schizophrenia, and highlights challenges to be addressed with future research. Methods We review (1) epidemiological information on the prevalence and correlates of developmental antecedents of schizophrenia in the general child population, (2) evidence of psychosocial, cognitive, and biological dysfunctions in at-risk children presenting multiple antecedents of schizophrenia and at-risk children with a family history of schizophrenia, and (3) related findings from an associated sample of helpseeking children receiving intervention. Results Community-based screening of 9-11-year olds identified *9 % with a triad of antecedents of schizophrenia [including psychotic-like experiences (PLEs)] who are putatively at-risk of psychosis; these children reported greater exposure and responsivity to stressors, impairments in general intelligence and specific cognitive functions, brain structure and function abnormalities, and neuromotor dysfunction. Preliminary evidence suggests distressing PLEs are a viable target for cognitive-behavioural intervention in at-risk children. Conclusions Intervention in early, premorbid phases of illness might alleviate current difficulties and avert future schizophrenia using benign treatments. The CHADS programme has identified several markers that may index early pathophysiology and constitute potential targets for preventative intervention.

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Section: Cognitive Impairmentsupporting

confidence: 53%

Toward earlier identification and preventative intervention in schizophrenia: evidence from the London Child Health and Development Study

Laurens

Cullen

2015

Soc Psychiatry Psychiatr Epidemiol

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“…16 Although there has been a great deal of interest in deficits in specific domains of cognition in psych otic illness, it is also well established that a general intellectual deficit is often comorbid with psychotic disorders and is a risk factor for such disorders. [60][61][62] Our results suggest that the rs1938526 risk variant of ANK3 is associated with significant and widespread reduction in cortical thickness and grey matter volume across diverse regions of the cortex. The thinning was so extensive that we increased our FDR-corrected threshold from p < 0.05 to p < 0.01 to highlight the regions most affected.…”

Section: Discussionmentioning

confidence: 65%

Association of a risk allele of ANK3 with cognitive performance and cortical thickness in patients with first-episode psychosis

Cassidy

Buchy

Bodnar

et al. 2014

J Psychiatry Neurosci

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“…Consistent with some findings of neurocognitive impairments in individuals at clinical high risk (19,20), a school-based study of children (age [11][12][13] in Ireland also reported an association of subclinical symptoms with impairment in processing speed and nonverbal working memory (21). Otherwise, little is known about neurocognitive functioning associated with early emerging subclinical spectrum symptoms in the general population.…”

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confidence: 68%

The psychosis spectrum in a young U.S. community sample: findings from the Philadelphia Neurodevelopmental Cohort

et al. 2014

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Little is known about the occurrence and predictors of the psychosis spectrum in large non-clinical community samples of U.S. youths. We aimed to bridge this gap through assessment of psychosis spectrum symptoms in the Philadelphia Neurodevelopmental Cohort, a collaborative investigation of clinical and neurobehavioral phenotypes in a prospectively accrued cohort of youths, funded by the National Institute of Mental Health. Youths (age 11-21; N57,054) and collateral informants (caregiver/legal guardian) were recruited through the Children's Hospital of Philadelphia and administered structured screens of psychosis spectrum symptoms, other major psychopathology domains, and substance use. Youths were also administered a computerized neurocognitive battery assessing five neurobehavioral domains. Predictors of psychosis spectrum status in physically healthy participants (N54,848) were examined using logistic regression. Among medically healthy youths, 3.7% reported threshold psychotic symptoms (delusions and/or hallucinations). An additional 12.3% reported significant subpsychotic positive symptoms, with odd/unusual thoughts and auditory perceptions, followed by reality confusion, being the most discriminating and widely endorsed attenuated symptoms. A minority of youths (2.3%) endorsed subclinical negative/disorganized symptoms in the absence of positive symptoms. Caregivers reported lower symptom levels than their children. Male gender, younger age, and non-European American ethnicity were significant predictors of spectrum status. Youths with spectrum symptoms had reduced accuracy across neurocognitive domains, reduced global functioning, and increased odds of depression, anxiety, behavioral disorders, substance use and suicidal ideation. These findings have public health relevance for prevention and early intervention.

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Cognitive Functioning in Prodromal Psychosis

Abstract: The HR state for psychosis is associated with significant and widespread impairments in neurocognitive functioning and social cognition. Subsequent transition to psychosis is particularly associated with deficits in verbal fluency and memory functioning.

Cited by 594 publications

References 86 publications

Toward earlier identification and preventative intervention in schizophrenia: evidence from the London Child Health and Development Study

Toward earlier identification and preventative intervention in schizophrenia: evidence from the London Child Health and Development Study

Association of a risk allele of ANK3 with cognitive performance and cortical thickness in patients with first-episode psychosis

The psychosis spectrum in a young U.S. community sample: findings from the Philadelphia Neurodevelopmental Cohort

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