Profile of cognitive deficits and associations with depressive symptoms and intelligence in chronic early‐onset schizophrenia patients

Abstract

Cognitive deficits in several domains have been demonstrated in early-onset schizophrenia patients but their profile and relation to depressive symptoms and intelligence need further characterization. The purpose was to characterize the profile of cognitive deficits in chronic, early-onset schizophrenia patients, assess the potential associations with depressive symptom severity, and examine whether cognitive deficits within several domains reflect intelligence impairments. This study compared attention, visual-construction, aspects of visual and verbal memory, and executive functions in chronic, early-onset schizophrenia patients (mean age = 20.7 years) (N = 18) and healthy controls (N = 38). Schizophrenia diagnoses were established at the time of the patients' first clinical presentation during childhood or adolescence and were confirmed five years later. In the chronic phase of early-onset schizophrenia, significant deficits were observed in all specific cognitive functions. The profile of cognitive deficits was jagged, and visual-construction, attention, and one aspect of verbal memory (verbal stories recall) were differentially impaired. Deficits of visual recall, visual recognition, and executive functions were accounted for by deficits in intelligence, while this was not the case for deficits of verbal recall of stories or attention. No significant associations were observed between the severity of cognitive deficits and that of depressive symptoms. Chronic, early-onset schizophrenia is characterized by a broad and jagged profile of cognitive deficits. Deficits of attention and verbal recall of stories appear not to be accounted for by deficits in intelligence, and the severity of cognitive deficits seems independent from that of depressive symptoms.

Gestational length affects neurocognition in early-onset schizophrenia

“…Results from the study indicate significant executive dysfunction in schizophrenia compared to both healthy controls and adults with schizophrenia Holmen et al, 2012b). Similar results are reported from research on other cognitive domains, whereas the EOS patients show increased deficiencies in IQ, verbal memory and speed of processing (Jepsen et al, 2013;Rajji et al, 2009).…”

“…The diversity of results led Schaefer et al (2013) to conclude that the main finding is the indication of a global cognitive impairment in schizophrenia, that are consistent over decades and across cultures. These conclusions have been supported in a meta-analysis by Fioravanti et al (2012), in a review article by Reichenberg (2010), as well as in several studies (Christensen et al, 2014;Jepsen et al, 2013;Mesholam-Gately et al, 2009;Nieto and Castellanos, 2011;Rajji et al, 2009). The schizophrenia population shows lower scores in a variety of cognitive domains, thus, a natural consequence has been a more frequent use of composite scores in cognitive studies of schizophrenia (Meyer et al, 2014;.…”

“…A small group of patients has an illness onset before 18 years of age, also referred to as early-onset schizophrenia spectrum disorders (EOS) . These youths often experience increased disease severity compared to those with later onset, with a worse clinical course and outcome (Remschmidt et al, 2007;Schimmelmann et al, 2007) and more profound cognitive deficits (Jepsen et al, 2013;Nieto and Castellanos, 2011;Rajji et al, 2009). Hence, finding reliable prognostic factors that help identify therapeutic targets, is important.…”

Do clinical characteristics predict the cognitive course in early‐onset schizophrenia‐spectrum disorders?

“…Research suggests that EOS reflects increased disease severity, with a worse clinical course and outcome (Remschmidt et al, 2007;Schimmelmann, Conus, Cotton, McGorry, & Lambert, 2007). The cognitive profile in EOS seems to be similar to adult-onset schizophrenia (AOS; Holmen, Juuhl-Langseth, Thormodsen, Melle, & Rund, 2010;Kravariti, Morris, Rabe-Hesketh, Murray, & Frangou, 2007;Oie, Sundet, & Ueland, 2011), but more impaired (Jepsen et al, 2013;Nieto & Castellanos, 2011;Rajji, Ismail, & Mulsant, 2009), and with a more pronounced developmental and premorbid anomaly (Frangou, 2013;Kumra & Charles Schulz, 2008;Teigset, Mohn, & Rund, 2016). EOS patients develop symptoms in a period with extensive brain maturation and alterations in cognitive structures and functions (Juuhl-Langseth, Holmen, Thormodsen, Oie, & Rund, 2014); thus, they provide unique neurodevelopmental data that may contribute to a better understanding of schizophrenia at all ages (Bombin et al, 2013;Rapoport, Giedd, & Gogtay, 2012;Remschmidt, 2002).…”

“…Although cognitive deficits do not appear in all cases (Rund, Zeiner, Sundet, Oie, & Bryhn, ), they are considered to be a core feature of schizophrenia (Palmer, Dawes, & Heaton, ; Rund et al., ; Torgalsboen, Mohn, & Rishovd Rund, ; Townsend & Norman, ), and they are more pronounced in schizophrenia than in bipolar disorders (Landro, Orbeck, & Rund, ; Seidman et al., ). While some studies argue for specific deficits, others suggest deficiencies across the cognitive domains (Christensen et al., ; Jepsen et al., ; Kravariti, Morris, Rabe‐Hesketh, Murray, & Frangou, ; Mesholam‐Gately, Giuliano, Goff, Faraone, & Seidman, ; Nieto & Castellanos, ; Rajji et al., ). A number of comprehensive meta‐analyses from both chronic and first‐episode schizophrenia suggest that essentially all cognitive domain are affected, with most effect sizes ranging from moderate to large (Heinrichs & Zakzanis, ; Mesholam‐Gately et al., ), and that the deficiencies are consistent over decades and across cultures (Schaefer, Giangrande, Weinberger, & Dickinson, ).…”