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Cognitive predictors of transition and remission of psychosis risk syndrome in a child and adolescent sample: longitudinal findings from the CAPRIS study

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Abstract

Cognitive impairments are proposed as predictors in the differentiation between subjects with psychosis risk syndrome (PRS) who will develop a psychotic disorder (PRS-P) and those who will not (PRS-NP). More in-depth study of the PRS-NP group could contribute to defining the role of cognitive alterations in psychosis. This study aims to analyze cognition of children and adolescents with PRS in terms of their clinical outcome at 18-month follow-up (psychosis, remission, and non-remission) and of determinate predictors of transition to psychosis and remission of PRS. The method is two-site, naturalistic, longitudinal study design, with 98 help-seeking adolescents with PRS and 64 healthy controls (HC). PRS-P (n = 24) and PRS-NP (n = 74) participants were clinically and cognitively assessed at baseline, and when full-blown psychotic disorder had developed or at 18-month follow-up. PRS-P subjects showed lower scores at baseline in processing speed, visuospatial memory, attention, and executive function (cognitive flexibility/processing speed) compared to HC. PRS-NP subjects showed lower baseline scores in verbal working memory and verbal fluency compared to HC. This deficit is also observed in the PRS group of participants still presenting attenuated psychotic symptoms at 18-month follow-up, while PRS subjects in remission showed a similar cognitive profile to HC subjects. Baseline score on processing speed, measured with a coding task, appeared to be a predictive variable for the development of a psychotic disorder. Performance in verbal working memory was predictive of remission in the PRS-NP. Post hoc comparisons indicate the need for careful interpretation of cognitive markers as predictors of psychosis. Cognitive impairments are present in both PRS-P and PRS-NP. Those individuals who recover from PRS show baseline cognitive performance comparable to the HC group. Together with sociodemographic variables, this observation could help in the differentiation of a variety of PRS trajectories in children and adolescents.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

IB would like to thank ISCIII for her support (INT19/00021). All the authors would like to thank all the participants in this study.

Funding

This study was supported by grants from the Carlos III Institute (ISCIII), Spanish Department of Health (Fondo de Investigación Sanitaria PI11/1349; PI11/02684; PI15/0444; PI15/00509, PI18/0242, PI18/0976, PI21/0396, PI21/0090, PI21/0330), CIBERSAM Network, Fundación Alicia Koplowitz, and Fondos FEDER, “Una manera de hacer Europa”.

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  1. Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain

    Jordina Tor, Anna Sintes-Estevez, Daniel Muñoz-Samons, Javier Álvarez-Subiela & Montserrat Dolz

  2. Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002, 08950, Esplugues de Llobregat, Barcelona, Spain

    Jordina Tor, Anna Sintes-Estevez, Daniel Muñoz-Samons, Javier Álvarez-Subiela & Montserrat Dolz

  3. Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Universitari of Barcelona, (2017SGR881), Barcelona, Spain

    Inmaculada Baeza, Elena De la Serna, Olga Puig & Gisela Sugranyes

  4. Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain

    Inmaculada Baeza, Elena De la Serna & Montserrat Dolz

  5. Institut d’Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain

    Inmaculada Baeza, Olga Puig & Gisela Sugranyes

  6. Health Sciences Division, Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain

    Inmaculada Baeza

Authors
  1. Jordina Tor
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  2. Inmaculada Baeza
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  3. Anna Sintes-Estevez
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  4. Elena De la Serna
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  5. Olga Puig
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  6. Daniel Muñoz-Samons
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  7. Javier Álvarez-Subiela
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  8. Gisela Sugranyes
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  9. Montserrat Dolz
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Contributions

MD and IB designed the study and wrote the protocol. JT manages the literature search, performed data analysis and wrote the first draft. All authors contributed to the planning of the study and enrolling participants. All authors critically reviewed the paper, and have approved the final manuscript.

Corresponding author

Correspondence to Jordina Tor.

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Conflict of interest

JT, AS, ES, OP, and DM declare that they have no conflict of interest. JA has received support to attend conferences or honoraria for lectures from Otsuka-Lundbeck and Janssen, Shire, Rubio, and Exeltis Healthcare. Dr. Sugranyes has received grants from the Spanish Ministry of Health, Instituto de Salud Carlos III «Health Research Fund»/ FEDER funds (PI18/00976; PI21/00330); Fundació Clínic Recerca Biomèdica (Ajut a la Recerca Pons Bartran), Alicia Koplowitz Foundation; European Commission (grant Number 101057529); the Brain and Behaviour Research Foundation (NARSAD Young Investigator Award ID 26731); and the Government of Catalonia (PERIS award SLT006/17/00362). She has received speaker fees from Angelini Pharma and consulting fees from Fenix Group. IB has received grants from the Spanish Ministry of Health, Instituto de Salud Carlos III (PI11/1349; PI15/0444; PI18/0242; PI21/0396) and Fundación Alicia Koplowitz, financial support from ISCIII (INT19/00021) and has received support to attend conferences or speaker fees from Otsuka-Lundbeck, Angelini, and Janssen. MD has received grants from Fundación Alicia Koplowitz; the Spanish Ministry of Health, Instituto de Salud Carlos III (PI11/02684; PI15/00509; PI21/0090) and she has received support to attend conferences or speaker fees from Shire, Janssen and Osuka-Lundbeck.

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Tor, J., Baeza, I., Sintes-Estevez, A. et al. Cognitive predictors of transition and remission of psychosis risk syndrome in a child and adolescent sample: longitudinal findings from the CAPRIS study. Eur Child Adolesc Psychiatry 33, 89–104 (2024). https://doi.org/10.1007/s00787-022-02137-w

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