Neurotoxicity Research

, Volume 18, Issue 3, pp 272–286

Neurocognitive Indicators of Clinical High-Risk States for Psychosis: A Critical Review of the Evidence


DOI: 10.1007/s12640-010-9191-1

Cite this article as:
Pukrop, R. & Klosterkötter, J. Neurotox Res (2010) 18: 272. doi:10.1007/s12640-010-9191-1


The present review investigates the empirical evidence from cross-sectional and long-term follow-up studies on neurocognitive indicators of an increased risk for developing schizophrenia spectrum psychoses in clinically defined high-risk samples. First, the investigations at the Cologne center for early recognition and intervention are briefly summarized and then integrated within the available literature. Thirty-two studies with original data could be identified by extensive literature search. Cross-sectional investigations of neurocognitive baseline assessments in high-risk samples with unknown conversion status have produced rather inconsistent results. Nevertheless, most convincing evidence could be collected for abnormal functioning in processing speed measures (digit symbol coding, Trailmaking Test-B, Stroop Color Naming), the Continuous Performance Test, verbal working memory measures, verbal memory and learning, and verbal fluency, though negative findings have also been reported in every instance. Moreover, high-risk subjects were found to perform both at the schizophrenia performance level and at a close to normal level. Longitudinal follow-up assessments provided predictive evidence with regard to psychosis conversion for measures of processing speed and of verbal memory and learning. However, a substantial number of negative findings does not allow for straight-forward conclusions. Finally, some reasons for inconsistent findings are discussed critically speculating on demographic differences, reliability and sample sizes, and conceptual imprecision in communicating results.


Clinical high riskProdromal schizophreniaCognitionNeuropsychologyReview

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of Psychiatry and PsychotherapyUniversity of CologneCologneGermany