Change in neuropsychological functioning over one year in youth at clinical high risk for psychosis

SCHIZOPHRENIA RESEARCH

卷:146

Article

Woodberry, Kristen A.^1,2  McFarlane, William R.³  Giuliano, Anthony J.^1,2  Verdi, Mary B.³  Cook, William L.³  Faraone, Stephen V.^4,5  Seidman, Larry J.^1,2,6 

[1] Beth Israel Deaconess Med Ctr, Dept Psychiat, Boston, MA USA

[2] Harvard Univ, Sch Med, Cambridge, MA 02138 USA

[3] Maine Med Ctr, Dept Psychiat, Portland, ME 04102 USA

[4] SUNY Syracuse, Med Genet Res Ctr, Syracuse, NY USA

[5] SUNY Syracuse, Upstate Med Univ, Dept Psychiat, Syracuse, NY USA

[6] Harvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Psychiat, Cambridge, MA 02138 USA

关键词: Prodrome;    Cognition;    Longitudinal;    Schizophrenia;    Decline;    PIER;   

DOI  :  10.1016/j.schres.2013.01.017

来源: Elsevier

【 摘 要 】

Schizophrenia and related psychotic disorders are associated with significant neuropsychological (NP) impairments. Yet the onset and developmental evolution of these impairments remains incompletely characterized. This study examined NP functioning over one year in a sample of youth at clinical high risk (CHR) for psychosis participating in a treatment study. We assessed functioning across six cognitive domains at two time points in a sample of 53 CHR and 32 healthy comparison (HC) subjects. Linear regression of HC one-year scores was used to predict one-year performance for CHR from baseline scores and relevant demographic variables. We used raw scores and MANOVAs of the standardized residuals to test for progressive impairment over time. NP functioning of CHR at one year fell significantly below predicted levels. Effects were largest and most consistent for a failure of normative improvement on tests of executive function. CHR who reached the highest positive symptom rating (6, severe and psychotic) on the Structured Interview of Prodromal Syndromes after the baseline assessment (n=10/53) demonstrated a particularly large (d=-1.89), although non-significant, discrepancy between observed and predicted one-year verbal memory test performance. Findings suggest that, although much of the cognitive impairment associated with psychosis is present prior to the full expression of the psychotic syndrome, some progressive NP impairments may accompany risk for psychosis and be greatest for those who develop psychotic level symptoms. (C) 2013 Elsevier B.V. All rights reserved.

【 授权许可】

Free