Neurocognition and conversion to psychosis in adolescents at high-risk

Abstract

This study examined neurocognitive predictors of conversion to Axis I psychosis among adolescents at high-risk for psychosis (AHRP). There were no significant differences in neurocognitive performance between adolescents at high-risk for psychosis who converted (AHRP+) and adolescents at high-risk for psychosis who did not convert (AHRP−). Within-sex comparisons revealed a relation between risk status and performance among females, with AHRP+ performing below AHRP−, but this effect did not hold for males. Between-sex comparisons revealed AHRP− males performed worse than AHRP− females on several measures. Across groups, males performed better than their female counterparts on select measures. Results are discussed in terms of implications for use of neurocognitive profiles as bio-risk markers of psychosis, while considering sex differences. Keywordspsychosis; high-risk; adolescents; cognition; sex differences; bio-risk markers Neurocognitive deficits are a well-established characteristic of schizophrenia (see Green et al., 2006). Despite strong evidence of poor premorbid intellectual functioning (for a meta-analytic review, see Aylward et al., 1984;Seidman et al., 2006;Reichenberg et al., 2006) and literature suggesting subtle functional impairments in years preceding clinical onset (e.g., , only a few studies have examined neurocognitive functioning among high-risk youth in relationship to vulnerability for conversion to Axis I psychosis.There are some recent reports of neurocognitive impairments among clinical high-risk individuals (Gschwandtner et al., 2003), including adolescents meeting criteria for schizophrenia prodromal syndrome (Hawkins et al., 2004) and youth with schizotypal personality disorder (SPD;Trotman et al., 2006), though others have not replicated this (Brewer et al., 2006). There are also some reports of a relation between cognitive dysfunction and conversion to psychosis in clinical high-risk groups (Lencz et al., 2006;Keefe et al., 2006;Brewer et al., 2005). Specifically, two investigations revealed that poorer verbal memory predicted psychosis outcome (Brewer et al., 2005;Lencz et al., 2006). Another showed that a Corresponding author: Deborah J. Walder, Department of Psychology, Brooklyn College of The City University of New York, Phone: (718) 951-5000, x. 6013, FAX: (718) 951-4814, E-mail: dwalder@brooklyn.cuny.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Bilder et al., 2000; Gittelman-Klein and Klen, 1969;Erlenmeyer-Kimling et al., 1984). The vast majority of studies indicate better premorbid functioning during childhood among fe...

Striatal abnormalities and spontaneous dyskinesias in non-clinical psychosis

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Neurocognitive Indicators of Clinical High-Risk States for Psychosis: A Critical Review of the Evidence

“…Using a perceptual organization task, Silverstein et al (2006) did not find any differences between converters to psychosis (n = 24) and those HR subjects who developed mood disorders after 1.5-2 years. Another study (Walder et al 2008) could not identify significantly different baseline assessments for converters (n = 12) and nonconverters after 4 years in fullscale IQ (WAIS), verbal and visual memory (WMS), and verbal working memory (LNS). However, there were differences in memory scores between female converters and nonconverters, but the low number of female converters (n = 6) did not allow for valid conclusions on sex differences.…”

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