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Level and pattern of neuropsychological functioning in early-onset psychoses

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Abstract

The present study aimed to compare the level and pattern of cognitive deficits in patients with early-onset psychoses with an age, gender and IQ matched control group. In order to ensure a representative sample of patients with psychoses, participants with an IQ of less than 70 were included. Forty-eight patients with an onset of psychoses before the age of 16, and 47 age, gender and IQ matched controls without psychoses were recruited. Psychotic symptomatology was assessed using the Schedules for Clinical Assessment to obtain DSM-IV and ICD-10 diagnoses. Positive and negative symptoms were assessed using the Positive and Negative Symptoms Scale. Levels of cognitive function were measured using a comprehensive neuropsychological battery. A pattern of specific impairments was not found, with few significant differences between the two cohorts. However both cohort groups performed lower than age derived norms. Therefore it appears that there are global cognitive deficits rather than specific deficits in early-onset psychoses when compared to normative data, in-line with conclusions of early-onset schizophrenia research, but patients did not have greater deficit than controls when matched on IQ, gender and age, even after excluding participants with IQ less than 70.

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References

  1. Frangou S, Hadjulis M, Vourdas A (2008) The Maudsley early onset schizophrenia study: cognitive function over a 4-year follow-up period. Schizophr Bull 34:52–59

    Article  PubMed  Google Scholar 

  2. Øie M, Sundet K, Rund BR (2008) Neurocognitive decline in early-onset schizophrenia compared with ADHD and normal controls: evidence from a 13-year follow-up study. Schizophr Bull 36(3):557–565

    Article  PubMed  Google Scholar 

  3. McClellan J, Prezbindowski A, Breiger D, McCurry C (2004) Neuropsychological functioning in early-onset psychotic disorders. Schizophr Res 68(1):21–26

    Article  PubMed  Google Scholar 

  4. Watkins JM, Asarnow RF, Tanguay PE (1988) Symptom development in childhood onset schizophrenia. J Child Psychol Psychiatry 29:865–878

    Article  PubMed  CAS  Google Scholar 

  5. Petty LK, Ornitz EM, Michelman JD, Zimmerman EG (1984) Autistic children who become schizophrenic. Arch Gen Psychiatry 41:129

    PubMed  CAS  Google Scholar 

  6. Kravariti E, Morris RG, Rabe-Hesketh S, Murray RM, Frangou S (2003) The Maudsley early-onset schizophrenia study: cognitive function in adolescents with recent onset schizophrenia. Schizophr Res 61(2–3):137–148

    Article  PubMed  Google Scholar 

  7. Øie M, Sundet K, Rund BR (1999) Contrasts in memory functions between adolescents with schizophrenia or ADHD. Neuropsychologia 37(12):1351–1358

    Article  PubMed  Google Scholar 

  8. Vance A, Hall N, Bellgrove MA, Casey M, Karsz F, Maruff P (2006) Visuospatial working memory deficits in adolescent onset schizophrenia. Schizophr Res 87(1–3):223–227

    Article  PubMed  CAS  Google Scholar 

  9. Kumra S, Wiggs E, Bedwell J, Smith AK, Arling E, Albus K, Hamburger SD, McKenna K, Jacobsen LK, Rapoport JL, Asarnow RF (2000) Neuropsychological deficits in pediatric patients with childhood-onset schizophrenia and psychotic disorder not otherwise specified. Schizophr Res 42:135–144

    Article  PubMed  CAS  Google Scholar 

  10. Kravariti E, Morris RG, Rabe-Hesketh S, Murray RM, Frangou S (2003) The Maudsley early-onset schizophrenia study: cognitive function in adolescent-onset schizophrenia. Schizophr Res 65:95–103

    Article  PubMed  Google Scholar 

  11. Asarnow RF, Asamen J, Granholm E, Sherman T, Watkins JM, Williams ME (1994) Cognitive/neuropsychological studies of children with a schizophrenic disorder. Schizophr Bull 20:647–669

    PubMed  CAS  Google Scholar 

  12. Jaeger J, Czobor P, Berns SM (2003) Basic neuropsychological dimensions in schizophrenia. Schizophr Res 65:105–116

    Article  PubMed  Google Scholar 

  13. González-Blanch C, Rodriquez-Sanchez JM, Perez-Iglesias R, Pardo-Garcia G, Martinez-Garcia O, Vazquez-Barquero JL, Crespo-Facorro B (2010) First-episode schizophrenia patients neuropsychologically within the normal limits: evidence of deterioration in speed of processing. Schizophr Res 119(1–3):18–26

    Article  PubMed  Google Scholar 

  14. Rodriguez-Sanchez JM, Crespo-Facorro B, Gonzalez-Blanch C, Perez-Iglesias R, Vazquez-Barquero JL (2007) Cognitive dysfunction in first-episode psychosis: the processing speed hypothesis. Br J Psychiatry 191(51):s107–s110

    Article  Google Scholar 

  15. MacDonald AW III, Goghari VM, Hicks BM, Flory JD, Carter CS, Manuck SB (2005) A convergent–divergent approach to context processing, general intellectual functioning, and the genetic liability to schizophrenia. Neuropsychology 19(6):814–821

    Article  PubMed  Google Scholar 

  16. Lussier I, Stip E (2001) Memory and attention deficits in drug naive patients with schizophrenia. Schizophr Res 48(1):45–55

    Article  PubMed  CAS  Google Scholar 

  17. Hoff AL, Harris D, Faustman WO, Beal M, DeVilliers D, Mone RD, Moses JA, Csernansky JG (1996) A neuropsychological study of early-onset schizophrenia. Schizophr Res 20(1–2):21–28

    Article  PubMed  CAS  Google Scholar 

  18. Meehl PE (1970) Nuisance variables and the ex-post facto design. In: Radner M, Winocur S (eds) Minnesota studies in the philosophy of science. University of Minnesota Press, Minneapolis, pp 373–402

    Google Scholar 

  19. Goldstein G, Shemansky WJ (1995) Influences on cognitive heterogeneity in schizophrenia. Schizophr Res 18(1):59–69

    Article  PubMed  CAS  Google Scholar 

  20. Weickert TW, Goldberg TE, Gold JM, Bieglow LB, Egan MF, Weinberger DR (2000) Cognitive impairments in patients with schizophrenia displaying preserved and compromised intellect. Arch Gen Psychiatry 57(9):907–913

    Article  PubMed  CAS  Google Scholar 

  21. Zabala A, Rapado M, Arango C, Robles O, de la Serna E, Gonzalez C, Rodriquez-Sanchez JM, Andres P, Mayoral M, Bombin I (2010) Neuropsychological functioning in early-onset first-episode psychosis: comparison of diagnostic subgroups. Eur Arch Psychiatry Clin Neurosci 260(3):225–233

    Article  PubMed  Google Scholar 

  22. Potter AI, Nestor PG (2010) IQ subtypes in schizophrenia: distinct symptom and neuropsychological profiles. J Nerv Ment Dis 198(8):580–585

    Article  PubMed  Google Scholar 

  23. Badcock JC, Dragovi M, Waters FAV, Jablensky A (2005) Dimensions of intelligence in schizophrenia: evidence from patients with preserved, deteriorated and compromised intellect. J Psychiatr Res 39(1):11–19

    Article  PubMed  Google Scholar 

  24. Oie M, Sundet K, Rund BR (2010) Neurocognitive decline in early-onset schizophrenia compared with ADHD and normal controls: evidence from a 13-year follow-up study. Schizophr Bull 36(3):557–565

    Article  PubMed  Google Scholar 

  25. Arango C, Moreno C, Martinez S, Parellada M, Desco M, Moreno D, Fraguas D, Gogtay N, James A, Rapoport J (2008) Longitudinal brain changes in early-onset psychosis. Schizophrenia Bull 34(2):341–353

    Article  Google Scholar 

  26. Gillberg C, Wahlstrom J, Forsman A, Hellgren L, Gillberg C (1986) Teenage psychoses-epidemiology, classification and reduced optimality in the pre-, peri- and neonatal periods. J Child Psychol Psychiatry 27(1):87–98

    Article  PubMed  CAS  Google Scholar 

  27. Castro-Fornieles J, Parellada M, Gonzalez-Pinto A, Moreno D, Graell M, Baeza I, Otero S, Soutullo CA, Crespo-Facorro B, Ruiz-Sancho A, Desco M, Rojas-Corrales O, Patino A, Carrasco-Marin E, Arango C (2007) The child and adolescent first-episode psychosis study (CAFEPS): design and baseline results. Schizophr Res 91(1–3):226–237

    Article  PubMed  Google Scholar 

  28. Fraguas D, de Castro MJ, Medina O, Parellada M, Moreno D, Graell M, Merchan-Naranjo J, Arango C (2008) Does diagnostic classification of early-onset psychosis change over follow-up? Child Psychiatry Hum Dev 39(2):137–145

    Article  PubMed  Google Scholar 

  29. Werry JS, McClellan J, Chard L (1991) Childhood and adolescent schizophrenia, bipolar and schizoaffective disorder: a clinical outcome study. J Am Acad Child Adolesc Psychiatry 30(3):457–465

    Article  PubMed  CAS  Google Scholar 

  30. Castle DJ, Wessely S, Van Os J, Murray RM (1998) Psychosis in the inner city: the Camberwell first episode study. Psychology Press Ltd, Hove

    Google Scholar 

  31. Correll CU, Lencz T, Smith CW, Auther AM, Nakayama EY, Hovey L, Olsen R, Shah M, Foley C, Cornblatt BA (2005) Prospective study of adolescents with subsyndromal psychosis: characteristics and outcomes. J Child Adolesc Psychopharmacol 15:418–433

    Article  PubMed  Google Scholar 

  32. Menzes NM, Milovan E (2000) First-episode psychosis: a comparative review of diagnostic evolution and predictive variables in adolescents versus adults. Can J Psychiatry 45:710–716

    Google Scholar 

  33. Mayoral M, Zabala A, Robles O, Bombin I, Andres P, Parellada M, Moreno D, Graell M, Medina O, Arango C (2008) Neuropsychological functioning in adolescents with first episode psychosis: a two-year follow-up study. Eur Psychiatry 23(5):375–383

    Article  PubMed  CAS  Google Scholar 

  34. Verdoux H, Liraud F, Assens F, Abalan F, van Os J (2002) Social and clinical consequences of cognitive deficits in early psychosis: a two-year follow-up study of first-admitted patients. Schizophr Res 56:149–159

    Article  PubMed  Google Scholar 

  35. Edwards J, McGorry PD, Waddell FM, Harrigan SM (1999) Enduring negative symptoms in first-episode psychosis: comparison of six methods using follow-up data. Schizophr Res 40:147–158

    Article  PubMed  CAS  Google Scholar 

  36. Singh SP, Cooper JE, Fisher HL, Tarrant J, Lloyd T, Banjo J, Corfe S, Jones P (2005) Measuring onset in first-episode psychosis: the Nottingham onset schedule (NOS). Schizophr Res 41(1):180

    Article  Google Scholar 

  37. Werry JS (1992) Child and adolescent (early-onset) schizophrenia: a review in light of DSM-III-R. J Autism Dev Disord 22(4):601–624

    Article  PubMed  CAS  Google Scholar 

  38. World Health Organisation (1994) Schedules for Clinical Assessment in Neuropsychiatry. Version 2. Am Psychiatric Pub

  39. American Psychiatric Association (1987) The Diagnostic and Statistical Manual for Mental Disorders. American Psychiatric Association, Washington, DC

  40. World Health Organisation (1994) The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD-10) Geneva

  41. McGuffin P, Farmer A, Harvey L (1991) A polydiagnostic application of operational criteria in studies of psychotic illness. Arch Gen Psychiatry 48:764–770

    PubMed  CAS  Google Scholar 

  42. Kay SR, Fisbein A, Opler LA (1987) The positive and negative symptom scale (PANSS) for schizophrenia. Schizophr Bull 1:261–276

    Google Scholar 

  43. Baron-Cohen S, Gillberg C (1992) Can autism be detected at 18 months? The needle, the haystack, and the CHAT. Br J Psychiatry 161:839

    Article  PubMed  CAS  Google Scholar 

  44. Wechsler D (1992) Wechsler intelligence scale for children, 3rd edn. The Psychological Corporation, London

    Google Scholar 

  45. Wechsler D (1992) Wechsler Adult Intelligence Scale—Revised. WAIS-R. The Psychological Corporation, New York

    Google Scholar 

  46. Crawford JR, Allan KM, Jack AM (1992) Short forms of the UK WAIS-R: regression equations and their predictive accuracy in a general population sample. Br J Clin Psychol 31:191–202

    Article  PubMed  Google Scholar 

  47. Britton PG, Savage RD (1966) A short form of the WAIS for use with the aged. Br J Psychiatry 112:289–299

    Google Scholar 

  48. Gathercole SE, Willis C, Emslie H (1994) The children’s test of nonword repetition: a test of phonological working memory. Memory 2:103–127

    Article  PubMed  CAS  Google Scholar 

  49. Gathercole SE, Baddeley A (1996) Adult test of nonword repetition. University of Bristol, Bristol

    Google Scholar 

  50. Keefe RS, Roitman SE, Harvey PD, Blum CS, DuPre RL, Prieto DM, Davidson M, Davis KL (1995) A pen-and-paper human analogue of a monkey prefrontal cortex activation task: spatial working memory in patients with schizophrenia. Schizophr Res 17(1):25–33

    Article  PubMed  CAS  Google Scholar 

  51. Cohen M (1997) Children’s memory scale. The Psychological Corporation, San Antonio

    Google Scholar 

  52. Gold JM, Carpenter C, Randolph C, Goldberg TE, Weinberger DR (1997) Auditory working memory and Wisconsin card sorting test performance in schizophrenia. Arch Gen Psychiatry 54(2):159–165

    PubMed  CAS  Google Scholar 

  53. Reitan RM, Wolfson D (1985) The Halstead–Reitan neuropsychological test battery. Neuropsychology Press, Tucson

    Google Scholar 

  54. Bechtoldt HP, Benton AL, Fogel ML (1962) An application of factor analysis in neuropsychology. Psychol Rec 12:147–156

    Google Scholar 

  55. Warrington EK (1996) The Camden memory tests. Erlbaum, Hove

    Google Scholar 

  56. Happe F (1994) An advanced test of theory of mind: understanding of story characters’ thoughts and feelings by able autistic, mentally handicapped, and normal children and adults. J Autism Dev Disord 24(2):129–154

    Article  PubMed  CAS  Google Scholar 

  57. Robertson IH, Ridgeway V, Nimmo-Smith I (1994) Test of everyday attention for children—TEA-Ch. Thames Valley Test Company

  58. Heinrichs RW, Zakzanis KK (1998) Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 12(3):426–445

    Article  PubMed  CAS  Google Scholar 

  59. Wechsler D (1987) Manual for the Wechsler memory scale—revised. The Psychological Corporation, New York

    Google Scholar 

  60. Fossati P, Amar G, Raoux N, Ergis AM, Allilaire JF (1999) Executive functioning and verbal memory in young patients with unipolar depression and schizophrenia. Psychiatry Res 89(3):171–187

    Article  PubMed  CAS  Google Scholar 

  61. Gold S, Arndt S, Nopoulos P, O’Leary DS, Andreasen NC (1999) Longitudinal study of cognitive function in first-episode and recent onset schizophrenia. Am J Psychiatry 156(9):1342–1348

    PubMed  CAS  Google Scholar 

  62. Wolf R, Vasic N, Hose A, Spitzer M, Walter H (2007) Changes over time in frontotemporal activation during a working memory task in patients with schizophrenia. Schizophr Res 91(1–3):141–150

    Article  PubMed  Google Scholar 

  63. Rund BR, Melle I, Friis S, Johannessen JO, Larsen TK, Midboe LJ, Opjordsmoen S, Simonsen E, Vaglum P, McGlashan T (2007) The course of neurocognitive functioning in first-episode psychosis and its relation to premorbid adjustment, duration of untreated psychosis, and relapse. Schizophr Res 91(1–3):132–140

    Article  PubMed  Google Scholar 

  64. Gold JM (2004) Cognitive deficits as treatment targets in schizophrenia. Schizophr Res 72(1):21–28

    Article  PubMed  Google Scholar 

  65. Albus M, Hubmann W, Mohr F, Hecht S, Hinterberger-Weber P, Seitz NN, Kuchenhoff H (2006) Neurocognitive functioning in patients with first-episode schizophrenia: results of a prospective 5-year follow-up study. Eur Arch Psychiatry Clin Neurosci 256(7):442–451

    Article  PubMed  Google Scholar 

  66. Leeson VC, Sharma P, Harrison M, Ron MA, Barnes TRE, Joyce EM (2009) IQ trajectory, cognitive reserve, and clinical outcome following a first episode of psychosis: a 3-year longitudinal study. Schizophr Bull 37(4):768–777

    Article  PubMed  Google Scholar 

  67. Hoff AL, Svetina C, Shields G, Stewart J, DeLisi LE (2005) Ten year longitudinal study of neuropsychological functioning subsequent to a first episode of schizophrenia. Schizophr Res 78(1):27–34

    Article  PubMed  Google Scholar 

  68. Stirling JD, White C, Lewis S, Hopkins R, Tantam D, Huddy A, Montague L (2003) Neurocognitive function and outcome in first episode schizophrenia: a 10 year follow up of epidemiological cohort. Schizophr Res 65(2–3):75–86

    Article  PubMed  Google Scholar 

  69. Frangou S, Hadjulis M, Vourdas A (2007) The Maudsley early onset schizophrenia study: cognitive function over a 4-year follow-up period. Schizophr Bull 34(1):52–59

    Article  PubMed  Google Scholar 

  70. Hill SK, Schuepbach D, Herbener ES, Keshavan MS, Sweeney JA (2004) Pretreatment and longitudinal studies of neuropsychological deficits in antipsychotic-naïve patients with schizophrenia. Schizophr Res 68(1):49–63

    Article  PubMed  Google Scholar 

  71. Hoff AL, Sakuma M, Wieneke M, Horon R, Kushner M, DeLisi LE (1999) Longitudinal neuropsychological follow-up study of patients with first-episode schizophrenia. Am J Psychiatry 156(9):1336–1341

    PubMed  CAS  Google Scholar 

  72. Woodward ND, Purdon SE, Meltzer HY, Zald DH (2005) A meta-analysis of neuropsychological change to clozapine, olanzapine, quetiapine, and risperidone in schizophrenia. Int J Neuropsychopharmacol 8(3):457–472

    Article  PubMed  CAS  Google Scholar 

  73. Keefe RS, Silva SG, Perkins DO, Lieberman JA (1999) The effects of atypical antipsychotic drugs on neurocognitive impairment in schizophrenia: a review and meta-analysis. Schizophr Bull 25(2):201–222

    PubMed  CAS  Google Scholar 

  74. Friss S, Sundet K, Rund BR, McGlashan TH (2002) Neurocognitive dimensions characterising patients with first-episode psychosis. Br J Psychiatry 181(43):s85–s90

    Article  Google Scholar 

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Authors and Affiliations

  1. Division of Child and Adolescent Psychiatry, Medical School, Queen’s Medical Centre, University of Nottingham, E Floor, South Block, Nottingham, NG7 2UH, UK

    D.-M. Walker

  2. Division of Rehabilitation and Ageing, Medical School, Queen’s Medical Centre, University of Nottingham, B Floor, Nottingham, NG7 2UH, UK

    P. J. Standen

  3. Nottingham Integrated Clinical Research Centre, The Research Design Service for the East Midlands (NDL), Room 2400, C Floor, South Block, Queen’s Medical Centre, Nottingham, NG7 2UH, UK

    D.-M. Walker

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Walker, DM., Standen, P.J. Level and pattern of neuropsychological functioning in early-onset psychoses. Eur Child Adolesc Psychiatry 20, 551–560 (2011). https://doi.org/10.1007/s00787-011-0219-8

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