Neurocognitive deficits in the (putative) prodrome and first episode of psychosis. Schizophr Res 93(1-3):266-277

University of Utah, USA.
Schizophrenia Research (Impact Factor: 3.92). 08/2007; 93(1-3):266-77. DOI: 10.1016/j.schres.2007.03.013
Source: PubMed


International research programs have contributed to the creation of operationally defined criteria to identify individuals at risk for schizophrenia. Although there has been substantial progress in the prospective study of the schizophrenia prodrome, the utility of current diagnostic criteria remains questionable because of the relatively low base rates of incident psychoses, the high false-positive rate and ethical concerns regarding the treatment of individuals at risk. The identification of brain based neurocognitive vulnerability markers for schizophrenia may contribute to the development of an at risk algorithm with greater predictive accuracy.
Forty subjects at risk (AR) for schizophrenia, 15 in their first episode (FE) of schizophrenia, and 36 healthy comparison (HC) subjects were administered a neurocognitive battery that assessed the domains of processing speed, working memory, verbal episodic memory, executive functioning and general intelligence.
At baseline, AR subjects showed neurocognitive deficits across all domains compared to HC subjects that were less severe than those observed in the FE sample. In preliminary analyses, AR subjects who later converted to psychosis (N=5) had greater neurocognitive impairment at baseline evaluation compared to those individuals who remained "at risk" at follow-up.
Neurocognitive deficits may be important in the pathogenesis of early psychosis and could help to define individuals at greatest risk for schizophrenia. Continued research in larger cohorts is needed to test the validity of this neurocognitive profile and its utility as a vulnerability marker.

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Available from: Kristin S Cadenhead, Sep 15, 2014
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    • "A growing body of literature points to pervasive neurocognitive and social cognitive impairments as fundamental aspects of the expression of schizophrenia (e.g., Cirillo and Seidman, 2003; Brewer et al., 2005; Keefe et al., 2006; Eastvold et al., 2007; Becker et al., 2010; Kim et al., 2011). Deficits in perception, speed of processing, working memory, attention, executive function, social cue perception, and social and action control are recorded even before illness onset, and are associated with poor functional, societal and occupational outcome (Green et al., 2000, 2012; Edwards et al., 2001; Lencz et al., 2006; Niendam et al., 2006; Seidman et al., 2006; Simon et al., 2007; Chan et al., 2010; Kohler et al., 2010; Billeke and Aboitiz, 2013). "
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    • "With this in mind, and supporting the concept of a continuum of neurocognitive function in psychotic spectrum disorders, it is possible that the factors that precipitate the transition from premorbid to prodromal stage are not necessarily distinct from those involved in the transition to psychosis. In fact, cognitive impairments were found in recent studies of neuropsychological functioning at ultra-high risk subjects (Lencz et al., 2005; Niendam et al., 2006; Eastvold et al., 2007; Simon et al., 2007; Jahshan et al., 2010; Woodberry et al., 2010; Kim et al., 2011). The study of premorbid cognitive performance could therefore make it possible to identify potential premorbid markers for the transition to prodromal stage or full-threshold psychosis. "
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    • "At a group level, the range of cognitive deficits in UHR subjects seems to have an intermediate position between healthy comparison subjects and patients with first episode of schizophrenia [15, 40]. Notably, Eastvold et al. [40] compared the baseline neurocognitive profiles of individuals at risk who later converted to psychosis (true prodromals) to those individuals who have experienced their first episode of psychosis and healthy comparison subjects. "
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