Neurocognitive Profile in Adolescents with Early-Onset Schizophrenia: Clinical Correlates

University of California, Los Angeles, Los Ángeles, California, United States
Biological Psychiatry (Impact Factor: 10.26). 12/2005; 58(9):705-12. DOI: 10.1016/j.biopsych.2005.04.031
Source: PubMed


Neurocognitive impairments have been documented in adolescents with early-onset schizophrenia (EOS; onset by age 18) and are important treatment targets. Information concerning the severity, pattern, and clinical correlates of these deficits in EOS remains limited.
Tests assessing motor skills, attention, memory, visuospatial abilities and executive functioning were administered to 54 clinically stabilized adolescents with EOS and 52 age- and sex-matched healthy controls. Childhood-onset patients (onset by age 13) were compared to those with an adolescent onset of illness. Patients' neurocognitive profiles were compared to those of controls. Relationships between neurocognitive deficits and demographic and clinical characteristics were explored.
Neurocognitive profiles did not differ between childhood- and adolescent-onset participants. Patients showed a generalized neurocognitive deficit of 2.0 SDs compared to controls, with relative deficit in executive functioning and relative sparing of language and visuospatial abilities. Degree of generalized neurocognitive impairment was associated with premorbid adjustment and negative symptom severity (Adjusted R(2) = .39).
Results document both a significant generalized deficit and a relative deficit of executive functioning in adolescents with EOS. The overall pattern is similar to that observed in severely ill first-episode adult patients. The impairments across multiple neurocognitive domains suggest widespread brain dysfunction in EOS.

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    • "In some studies, severity of negative and disorganization symptoms correlate with cognitive impairment (Nieuwenstein et al. 2001; Schuepbach et al. 2002) also in adolescent subjects (Rhinewine et al. 2005) however correlations are usually modest. Results are not univocal and in some studies, especially in EOS population this link is not observed (Banaschewski et al. 2000). "
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    ABSTRACT: Cognitive functions are important determinants of outcome in schizophrenia. Psychiatric hospitalization and intensive treatment in the early-onset psychosis may reduce the severity of psychotic symptoms and improve cognitive functions. It is not clear if after discharge improvement or further deterioration of cognition is observed. The aim of the current study is the evaluation of executive functioning in early onset schizophrenia (EOS) across stages of illness. Two groups of EOS patients: hospitalized subjects with first episode (FES, n=16) at the introduction of pharmacotherapy (T1) and after mean 7 weeks (T2) and stable outpatients group (SO, n=24) were assessed with the Wisconsin Card Sorting Test (WCST) the Positive and Negative Syndrome Scale. Matched healthy (n=32) controls were assessed with WCST. All patients performed significantly worse in WCST than healthy controls. Subjects in acute psychotic episode (FES T1) presented more pronounced executive impairment and psychopathological symptoms than after the resolution of psychotic symptoms (FES T2). No differences in executive function between FES T2 and SO group were observed. In all assessments perseverative errors correlated with negative symptoms. Cognitive impairment is present at the onset of EOS and persists in attenuated but stable form after the resolution of psychotic symptoms.
    No preview · Article · May 2015 · Neuro endocrinology letters
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    • ". The d′ index is independent from differences in response rates ( Bergman et al . , 1995 ; Thaden et al . , 2006 ) and has shown a high sensitivity and specificity in discriminating healthy controls from patients with schizophrenia ( Cornblatt et al . , 1988 , 1992 , 1997 ; Cornblatt et al . , 1989b ; Egan et al . , 2000 ; Cosway et al . , 2002 ; Rhinewine et al . , 2005 ; Thaden et al . , 2006 ) ."
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    ABSTRACT: Aim To provide normative values for the healthy ethnic Chinese Singaporean population and a large sample of patients with schizophrenia for the Continuous Performance Task-Identical Pairs (CPT-IP). Participants Data were collected on 1011 healthy ethnic Chinese and 654 patients diagnosed with schizophrenia, all between 21 and 55 years of age. Methods Data were stratified by age and gender. The effects of age, gender and education were explored in patients and controls. Performance indices were assessed in their ability to predict group inclusion. Controls’ performance was compared with that reported in a US sample. Results Performance was affected by age, sex, and education, with youth, male sex and higher education providing a performance advantage. Patients’ performance was lower than controls’ by more than 1 standard deviation, with the 3-digit d′ score most significantly discriminating between controls and patients. The effects of socio-demographic factors on performance were in line with those conducted in the US and previously reported in the literature. Conclusions This is the largest norming study ever conducted on the CPT-IP. It will enable investigators and clinicians to select appropriate indices to assess severity of cognitive decline and/or evaluate cognitive remediation therapy outcomes after taking into account age, gender and education factors.
    Full-text · Article · Jul 2014 · Schizophrenia Research
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    • "Consistent with this multiple-deficit approach, an extensive literature suggests that COP and ADHD are associated with weaknesses in a wide range of neuropsychological domains, including processing speed and response Conflicts of interest statement: See Acknowledgements for disclosure. variability, stimulus detection and vigilance, working memory and other executive functions, and different aspects of motor control (e.g., Karatekin & Asarnow, 1998; Karatekin, Bingham, & White, 2009; Karatekin , White, & Bingham, 2008, 2009a; Karatekin et al., 2009b; Rhinewine et al., 2005; Willcutt, Pennington, Olson, Chhabildas, & Hulslander, 2005; Willcutt et al., 2008, 2012). Despite hundreds of studies of the neuropsychological correlates of ADHD and COP, to our knowledge groups with ADHD and early-onset psychosis have only been compared directly on neuropsychological measures in two samples of children (Karatekin & Asarnow, 1998; Karatekin et al., 2008, 2009, 2009a, b) and two samples of adolescents (e.g., Groom, Bates, et al., 2008; Groom, Jackson, et al., 2008; Oie, Rund, & Sundet, 1998; Oie, Sunde, & Rund, 1999; Oie, Sundet, & Rund, 2010; Rund, Zeiner, Sundet, Oie, & Bryhn, 1998). "
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    ABSTRACT: Attention-deficit/hyperactivity disorder (ADHD) and childhood-onset psychosis (COP) are chronic, heterogeneous disorders with symptoms that frequently co-occur, but the etiology of their comorbidity is unknown. Studies of each disorder indicate that both ADHD and COP are associated with a range of neuropsychological weaknesses, but few neuropsychological studies have directly compared groups with ADHD and COP. Groups with ADHD only (32 F, 48 M), COP only (5 F, 5 M), ADHD + COP (9 F, 21 M), and a control group with neither disorder (25 F, 44 M) completed a neuropsychological battery that included measures of verbal working memory, response inhibition, response speed and variability, and selective attention. All three clinical groups exhibited significantly lower performance versus the control group on all neuropsychological measures, whereas the only significant difference between the clinical groups was a significantly larger weakness in verbal working memory in the groups with COP. The frequent co-occurrence between COP and ADHD may reflect shared neuropsychological weaknesses that are most pronounced on measures of working memory and response variability.
    Full-text · Article · Jan 2014 · Journal of Child Psychology and Psychiatry
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