Neurocognitive predictors of functional outcome two to 13years after identification as ultra-high risk for psychosis

Lin, Ashleigh; Wood, Stephen J.; Nelson, Barnaby; Brewer, Warrick J.; Spiliotacopoulos, Daniela; Bruxner, Annie; Broussard, Christina; Pantelis, Christos; Yung, Alison R.

doi:10.1016/j.schres.2011.06.014

Cited by 190 publications

(189 citation statements)

References 28 publications

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“…Recent work indicated that UHR cases who present with lower levels of negative symptoms and higher levels of social functioning are more likely to recover symptomatically, and no longer meet criteria for an at-risk mental state [32,33]. Due to consistent presence of negative symptoms in UHR candidates, measurement tools for psychopathology in at-risk individuals have included items about negative symptoms [34,35]. Our findings are consistent with what has been reported in the literature.…”

Section: Discussionsupporting

confidence: 88%

“…Second generation antipsychotics have claimed to have some success in treatment of negative symptoms though not without skepticism [8]. Recently, negative symptoms have been described in the early phase of the illness [9], first episode schizophrenia, drug naïve psychosis, and in ultra high risk (UHR) candidates [10]. Since negative symptoms are resistant to treatment, and lead to poor functional outcome it is likely that early identification in treatment of these symptoms may improve the outcome of schizophrenia [11].…”

Section: Introductionmentioning

confidence: 99%

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Study of negatives symptoms in first episode schizophrenia

Bambole¹,

Shah²,

Sonavane³

et al. 2013

OJPsych

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Background: Prevalence of negative symptoms in the early phase of schizophrenia remains uncertain. Negative symptoms are the primary cause of long term disability and poor functional outcome. The purpose of this study is to examine the presence of negative symptoms in patients with fist episode psychosis in schizophrenia who were hospitalized. Methods: Negative symptoms were measured in 72 patients presenting with FEP using the scale for assessment of negative symptoms (SANS) and ascertained diagnosis using DSM-IV. Prevalence of SANS items and subscales were examined for both schizophrenia and bipolar disorder. Results: This study shows that a significant number of patients with first episode schizophrenia had negative symptoms 66 (87.5%). All five subtypes of negative symptoms were present in 47% of patients suggesting primary negative symptoms, and about 40% have secondary negative symptoms. Independently, each subtype of negative symptoms was seen in 48% -76% of patients. The most prevalent negative symptom in first-episode schizophrenia was found to be blunting (72%). 46% of patients had significant level of depression, overall psychopathology was severe and level of functioning was poor. We found that 45.8% patients were prescribed anticholinergic medications which indicated that at least 45% subjects had extra-pyramidal symptoms (EPS). Conclusion: Primary negative symptoms are prevalent in about half of First episode Psychosis (FEP) schizophrenia patients. These findings have implications for identification, early treatment, and reduced treatment resistance for negative symptoms in order to increase social and clinical outcome of schizophrenia. Further research is required in this area.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Study of negatives symptoms in first episode schizophrenia

Bambole¹,

Shah²,

Sonavane³

et al. 2013

OJPsych

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“…Thus processing speed may be particularly good in capturing generalized dysfunction contributing to widespread cognitive failures in schizophrenia (Rodríguez-Sánchez et al, 2007). In addition, processing speed deficits have been observed in high-risk samples compared with healthy individuals (Seidman et al, 2010), at-risk subjects who converted to psychosis (Lin et al, 2011), and adolescents in the community who are prodromal for psychosis (Kelleher et al, 2013). There are also data indicating that poor social outcome can be predicted by reduced processing speed in a clinical high-risk sample for psychosis (Carrión et al, 2013;Faber et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Abnormal Resting State fMRI Activity Predicts Processing Speed Deficits in First-Episode Psychosis

Gallego

Robinson

Ikuta

et al. 2015

Neuropsychopharmacol

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Little is known regarding the neuropsychological significance of resting state functional magnetic resonance imaging (rs-fMRI) activity early in the course of psychosis. Moreover, no studies have used different approaches for analysis of rs-fMRI activity and examined gray matter thickness in the same cohort. In this study, 41 patients experiencing a first-episode of psychosis (including N ¼ 17 who were antipsychotic drug-naive at the time of scanning) and 41 individually age-and sex-matched healthy volunteers completed rs-fMRI and structural MRI exams and neuropsychological assessments. We computed correlation matrices for 266 regions-of-interest across the brain to assess global connectivity. In addition, independent component analysis (ICA) was used to assess group differences in the expression of rs-fMRI activity within 20 predefined publicly available templates. Patients demonstrated lower overall rs-fMRI global connectivity compared with healthy volunteers without associated group differences in gray matter thickness assessed within the same regions-of-interest used in this analysis. Similarly, ICA revealed worse rs-fMRI expression scores across all 20 networks in patients compared with healthy volunteers, with posthoc analyses revealing significant (po0.05; corrected) abnormalities within the caudate nucleus and planum temporale. Worse processing speed correlated significantly with overall lower global connectivity using the region-of-interest approach and lower expression scores within the planum temporale using ICA. Our findings implicate dysfunction in rs-fMRI activity in first-episode psychosis prior to extensive antipsychotic treatment using different analytic approaches (in the absence of concomitant gray matter structural differences) that predict processing speed.

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“…These neurocognitive deficits have been detected prior to the onset of illness [13,14] and observed to interact with symptom severity [15]. Neurocognitive compromise has also been implicated as a predictor of poorer response to psychosocial treatments [16].…”

Section: * E-mail: Plysaker@iupuiedumentioning

confidence: 99%

Synthetic metacognition as a link between brain and behavior in schizophrenia

Lysaker¹,

Bob

Pěč³

et al. 2013

Translational Neuroscience

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Deficits in metacognitive capacity in schizophrenia can be conceptualized as existing along a spectrum from more discrete to more synthetic activities. These capacities may be of great importance in schizophrenia research given their potential to mediate and moderate the impact of illness-related factors on outcome. To explore this possibility this review summarizes research on synthetic metacognition using a paradigm in which metacognitive capacity is rated on the basis of spontaneously produced personal narratives. Evidence from a review of the literature shows that these deficits are detectable in patients with schizophrenia and are related to, but not reducible to, symptom severity and poorer neurocognitive function. Independent of symptoms and neurocognition, deficits in synthetic metacognition, which are likely linked to the brain's ability to integrate information, are related to a range of outcomes including functional competence, learning potential, and insight. These deficits may also play a role in long term psychosocial functioning via their impact on the ability to sustain social functions.

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Neurocognitive predictors of functional outcome two to 13years after identification as ultra-high risk for psychosis

Cited by 190 publications

References 28 publications

Study of negatives symptoms in first episode schizophrenia

Study of negatives symptoms in first episode schizophrenia

Abnormal Resting State fMRI Activity Predicts Processing Speed Deficits in First-Episode Psychosis

Synthetic metacognition as a link between brain and behavior in schizophrenia

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