Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
Archival ReportNeurocognitive Assessments Are More Important Among Adolescents Than Adults for Predicting Psychosis in Clinical High Risk
Section snippets
Participants and Procedures
A total of 447 participants at CHR and 365 HC subjects aged 12 to 45 years were recruited through the extended phase of ShangHai At Risk for Psychosis (SHARP-extended) between 2016 and 2019. Of all individuals at CHR, 76 did not complete baseline neurocognitive tests, while 46 were lost to follow-up by the 2-year follow-up visit. The remaining 325 CHR participants completed neurocognitive assessments using the Chinese version of the MATRICS Consensus Cognitive Battery (MCCB) (18, 19, 20) at
Demographic, Clinical, and Cognitive Characteristics
Within the HC group, adolescents performed significantly worse than the adult group on category fluency and CPT-IP but significantly better on WMS-3 spatial span and BVMT-R (Table 1). Within the CHR group, adults performed significantly worse than the adolescent group on the BVMT-R test.
Neuropsychological Profile and Comparisons Between CHR Participants and HC Subjects
Both the CHR adolescents and CHR adults demonstrated significantly poorer performances than the HC subjects on all eight neurocognitive tests (Figure 1), except for performance on the CPT-IP test in adolescents (
Discussion
Although neurocognitive deficits have been widely used to predict psychosis from CHR status, very few studies have been conducted specifically for comparisons of cognitive performance between adolescents and adults at CHR. To our knowledge, this study is one of the largest sample sizes in which both the adolescent and adult CHR groups were matched to adolescent and adult HC groups, respectively. This study was based on a drug-naive CHR cohort sample at their first contact with mental health
Acknowledgments and Disclosures
This study was supported by the Ministry of Science and Technology of China, National Key R&D Program of China (Grant No. 2016YFC1306800), Science and Technology Commission of Shanghai Municipality (Grant Nos. 19441907800, 19ZR1445200, 17411953100, 16JC1420200, 2018SHZDZX01, 19410710800, 19411969100, and 19411950800), Shanghai Clinical Research Center for Mental Health (Grant No. 19MC1911100) and the Clinical Research Center at Shanghai Mental Health Center (Grant Nos. CRC2018ZD01 and
References (49)
- et al.
Neurocognition as a predictor of transition to psychotic disorder and functional outcomes in ultra-high risk participants: Findings from the NEURAPRO randomized clinical trial
Schizophr Res
(2019) - et al.
Neuropsychological performance in first-episode adolescents with schizophrenia: A comparison with first-episode adults and adolescent control subjects
Biol Psychiatry
(2006) - et al.
Prodromal psychosis detection in a counseling center population in China: An epidemiological and clinical study
Schizophr Res
(2014) - et al.
Cognitive dysfunction in a psychotropic medication-naive, clinical high-risk sample from the ShangHai-At-Risk-for-Psychosis (SHARP) study: Associations with clinical outcomes
Schizophr Res
(2020) - et al.
An ecologically valid performance-based social functioning assessment battery for schizophrenia
Psychiatry Res
(2013) - et al.
The MCCB impairment profile for schizophrenia outpatients: Results from the MATRICS psychometric and standardization study
Schizophr Res
(2011) - et al.
A comparison of conversion rates, clinical profiles and predictors of outcomes in two independent samples of individuals at clinical high risk for psychosis in China
Schizophr Res
(2018) - et al.
The Continuous Performance Test, identical pairs version (CPT-IP): I. New findings about sustained attention in normal families
Psychiatry Res
(1988) - et al.
Healthy adolescent performance on the MATRICS Consensus Cognitive Battery (MCCB): Developmental data from two samples of volunteers
Schizophr Res
(2016) - et al.
Dimensions of intelligence in schizophrenia: Evidence from patients with preserved, deteriorated and compromised intellect
J Psychiatr Res
(2005)
Cognition at illness onset as a predictor of later functional outcome in early psychosis: Systematic review and methodological critique
Schizophr Res
From the psychosis prodrome to the first-episode of psychosis: No evidence of a cognitive decline
J Psychiatr Res
Neurocognitive impairments in individuals at ultra-high risk for psychosis: Who will really convert?
Aust N Z J Psychiatry
Correlation of social cognition and neurocognition on psychotic outcome: A naturalistic follow-up study of subjects with attenuated psychosis syndrome
Sci Rep
Meta-analysis of cognitive deficits in ultra-high risk to psychosis and first-episode psychosis: Do the cognitive deficits progress over, or after, the onset of psychosis?
Schizophr Bull
Neurocognition in the psychosis risk syndrome: A quantitative and qualitative review
Curr Pharm Des
Age at onset and cognitive functioning in schizophrenia
Br J Psychiatry
Earlier age of first diagnosis in schizophrenia is related to impaired motor control
Schizophr Bull
Two-year follow-up of a Chinese sample at clinical high risk for psychosis: Timeline of symptoms, help-seeking and conversion
Epidemiol Psychiatr Sci
The developmental trajectories of executive function from adolescence to old age
Sci Rep
A developmental perspective on executive function
Child Dev
Early and late neurodevelopmental disturbances in schizophrenia and their functional consequences
Aust N Z J Psychiatry
Differential effects of age at illness onset on verbal memory functions in antipsychotic-naive schizophrenia patients aged 12-43 years
Psychol Med.
Age at onset and cognition in schizophrenia: Meta-analysis
Br J Psychiatry
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2022, Schizophrenia ResearchCitation Excerpt :Cognitive impairment is most evident in patients with chronic symptoms of psychosis, however, multiple studies report cognitive deficits in first-episode psychosis patients (FEP) (Sawada et al., 2017; Saykin, 1994; Simon et al., 2007), in those at clinical high-risk (CHR) for developing psychosis (Bolt et al., 2019; De Herdt et al., 2013; Gur et al., 2015a; Lencz et al., 2006; Reichenberg, 2005; Zhang et al., 2021a), and in those with sub-threshold psychosis spectrum (PS) symptoms (Gur et al., 2014; Gur et al., 2015b).
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2022, Current Opinion in PsychologyCitation Excerpt :Furthermore, the pattern of associations between cognition and PPSs and their subthreshold expressions in children of the community was similar to that seen in schizophrenia, whereby processing speed impairment was a particularly strong predictor of these phenomena in children [22]. With respect to conversion to full-blown psychosis, neurocognitive assessments predicted conversion much better in adolescents than in adults with a CHR state [35]. A study on minor patients with CHR reported general intelligence as the only variable predicting conversion, yet it was considered to be a less potent predictor compared with clinical variables [27].
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