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Neurocognitive impairments in individuals at ultra-high risk for psychosis: Who will really convert?

 Minji Bang  ;  Kyung Ran Kim  ;  Yun Young Song  ;  Seoyeon Baek  ;  Eun Lee  ;  Suk Kyoon An 
 Australian and New Zealand Journal of Psychiatry, Vol.49(5) : 462-470, 2015 
Journal Title
 Australian and New Zealand Journal of Psychiatry 
Issue Date
Adolescent ; Adult ; Attention ; Case-Control Studies ; Cognition Disorders/psychology* ; Executive Function ; Female ; Humans ; Intelligence ; Male ; Memory, Short-Term ; Multivariate Analysis ; Neuropsychological Tests ; Psychiatric Status Rating Scales ; Psychotic Disorders/diagnosis* ; Regression Analysis ; Risk Factors ; Schizophrenia/diagnosis* ; Schizophrenic Psychology* ; Young Adult
Neurocognition ; first-episode schizophrenia ; prediction ; spatial memory ; ultra-high risk for psychosis ; vulnerability
OBJECTIVE: Impairments in neurocognitive function are considered as core features of schizophrenia. Individuals at ultra-high risk (UHR) for psychosis, the 'putative' prodrome of schizophrenia, generally show levels of impairments intermediate between schizophrenia patients and healthy controls. We investigated the neurocognitive performance of individuals at UHR for psychosis, comparing them with patients with first-episode schizophrenia (FES) and healthy controls (HC), and explored the predictivity of baseline neurocognitive function in the UHR group for transition to overt psychosis. METHOD: Individuals at UHR for psychosis (n = 60), patients with FES (n = 39), and HC subjects (n = 94) participated in the present study. All participants performed a comprehensive neurocognitive battery, consisting of tests for five separate neurocognitive domains (executive function, attention/working memory, processing speed, verbal memory, and spatial memory). UHR subjects were assessed for transition every month during 24 months of follow-up. RESULTS: Neurocognitive performance in the UHR group was largely at intermediate levels. Attention/working memory and verbal memory were significantly different from both the FES and HC groups. In the UHR group, processing speed was decreased to the level of the FES group, while executive function and spatial memory were relatively preserved. In the Cox regression model, spatial memory significantly predicted the transition to overt psychosis in the UHR group. CONCLUSIONS: The present study showed that neurocognitive impairments were evident in UHR individuals prior to the onset of overt psychosis. Our findings generally support the neurodevelopmental model of schizophrenia and suggest that there could be different developmental trajectories between converters and non-converters.
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1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Ran(김경란) ORCID logo https://orcid.org/0000-0001-8375-1851
An, Suk Kyoon(안석균) ORCID logo https://orcid.org/0000-0003-4576-6184
Lee, Eun(이은) ORCID logo https://orcid.org/0000-0002-7462-0144
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