Patterns of premorbid functioning in individuals at clinical high risk of psychosis

Lyngberg, Kristina; Buchy, Lisa; Liu, Lu; Perkins, Diana O.; Woods, Scott W.; Addington, Jean

doi:10.1016/j.schres.2015.11.004

Cited by 26 publications

(23 citation statements)

References 22 publications

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“…Poor academic performance was related to an increased risk for schizophrenia, prior to the age of 16 (MacCabe et al, ). Although there are few studies in PRS samples (Lyngberg et al, ; Morcillo et al, ; Tikka et al, ) and even fewer in PRS youth samples, authors report worse premorbid adjustment in PRS compared with controls (Tarbox et al, ; Ziermans, Schothorst, Sprong, & van Engeland, ).…”

Section: Discussionmentioning

confidence: 99%

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Characterization of children and adolescents with psychosis risk syndrome: The Children and Adolescents Psychosis Risk Syndrome (CAPRIS) study

Dolz

Tor

Serna

et al. 2018

Early Intervention Psych

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Aim: Despite the interest in psychosis risk syndrome (PRS) in children and adolescents, information on the syndrome in this population is scarce.Methods: Prospective naturalistic multi-site study in which 10-to 17-year-old help-seeking subjects who met PRS criteria (positive or negative attenuated symptoms; brief limited intermittent psychotic symptoms; genetic risk or schizotypal personality disorder plus impairment in functioning) were included, along with 45 age and sex-matched healthy controls (HC). All subjects were clinically and functionally assessed. Results: Ninety-one PRS subjects (PRSS) with a mean age of 15.5 AE 1.4 met inclusion criteria (IC). Compared with HC, PRSS presented worse global and academic functioning in the previous year, had experienced more psychiatric and psychological problems, and presented gestational ages outside the normal range. More than 80% of PRSS met ≥2 IC, with 65.9% having one Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision diagnosis, and 61.7% of those having ≥2 diagnoses. Some 49.5% of PRSS had a first-or second-degree family history (FH) of psychosis. Patients with first-and second-degree FH do not differ in their clinical expression.Conclusions: Children and adolescents with PRS are a patient group with a pattern of neurodevelopmental impairment and clinical complexity similar to patients with schizophrenia spectrum disorders, highlighting the importance of assessing these variables in child and adolescent samples. PRSS with first-and second-degree relatives with FH do not present differences in their clinical presentation, suggesting that including these two groups of patients in the genetic risk criteria would enrich knowledge of these criteria. K E Y W O R D Schild and adolescent, clinical high risk for psychosis, psychosis, psychosis risk syndrome

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Section: Discussionmentioning

confidence: 99%

“…Although there are few studies in PRS samples (Lyngberg et al, 2015;Morcillo et al, 2015;Tikka et al, 2013) and even fewer in PRS youth samples, authors report worse premorbid adjustment in PRS compared with controls (Tarbox et al, 2013;Ziermans, Schothorst, Sprong, & van Engeland, 2011).…”

Section: Socio-demographic Characteristics Of the Samplementioning

confidence: 93%

Characterization of children and adolescents with psychosis risk syndrome: The Children and Adolescents Psychosis Risk Syndrome (CAPRIS) study

Dolz

Tor

Serna

et al. 2018

Early Intervention Psych

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“…This scale assesses sociability and social withdrawal, peer relationships, scholastic performance, adaptation to school, and the ability to form socio-sexual relationships across four different developmental periods of development: childhood (age 5–11), early adolescence (age 12–15), late adolescence (age 16–18), and adulthood (age 19 and above) (Cannon-Spoor et al, 1982). As premorbid functioning was defined as the period preceding the onset of the first attenuated psychotic symptom that contributed to the participant meeting COPS criteria, PAS ratings beyond the childhood period were not applicable for CHR individuals in early adolescence (age 12–17) (Lyngberg et al, 2015). Premorbid functioning was dichotomized into “poor” and “good” functioning group, by using a cutoff that is 1.5 SD above the mean in the healthy control group (0.38 of the total PAS score in childhood ranging from 0.0 to 1.0).…”

Section: Methodsmentioning

confidence: 99%

Cortical abnormalities in youth at clinical high-risk for psychosis: Findings from the NAPLS2 cohort

Chung

Allswede

Addington

et al. 2019

NeuroImage: Clinical

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In a recent machine learning study classifying “brain age” based on cross-sectional neuroanatomical data, clinical high-risk (CHR) individuals were observed to show deviation from the normal neuromaturational pattern, which in turn was predictive of greater risk of conversion to psychosis and a pattern of stably poor functional outcome. These effects were unique to cases who were between 12 and 17 years of age when their prodromal and psychotic symptoms began, suggesting that neuroanatomical deviance observable at the point of ascertainment of a CHR syndrome marks risk for an early onset form of psychosis. In the present study, we sought to clarify the pattern of neuroanatomical deviance linked to this “early onset” form of psychosis and whether this deviance is associated with poorer premorbid functioning. T 1 MRI scans from 378 CHR individuals and 190 healthy controls (HC) from the North American Prodrome Longitudinal Study (NAPLS2) were analyzed. Widespread smaller cortical volume was observed among CHR individuals compared with HC at baseline evaluation, particularly among the younger group (i.e., those who were 12 to 17 years of age). Moreover, the younger CHR individuals who converted or presented worsened clinical symptoms at follow-up (within 2 years) exhibited smaller surface area in rostral anterior cingulate, lateral and medial prefrontal regions, and parahippocampal gyrus relative to the younger CHR individuals who remitted or presented a stable pattern of prodromal symptoms at follow-up. In turn, poorer premorbid functioning in childhood was associated with smaller surface area in medial orbitofrontal, lateral frontal, rostral anterior cingulate, precuneus, and temporal regions. Together with our prior report, these results are consistent with the view that neuroanatomical deviance manifesting in early adolescence marks vulnerability to a form of psychosis presenting with poor premorbid adjustment, an earlier age of onset (generally prior to the age of 18 years), and poor long-term outcome.

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“…In addition, premorbid social withdrawal and impairments in peer relationships are present in over 50% of children with early onset schizophrenia (i.e., by the age of 15; Kolvin, 1971;Nicolson et al, 2000). Furthermore, social maladjustment in both early (age 12-15) and late (age 16-18) adolescence predicts conversion to schizophrenia in CHR youth (Dragt et al, 2011;Lyngberg et al, 2015;Tarbox et al, 2013Tarbox et al, , 2014Walder et al, 2013).…”

Section: Premorbid Social Dysfunction In Psychosis Populationsmentioning

confidence: 99%

Early childhood social communication deficits in youth at clinical high-risk for psychosis: Associations with functioning and risk

2019

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Effective social functioning requires a broad range of social communication skills that are impaired in psychosis populations. However, little is known about early childhood (4- to 5-year period) social communication during the premorbid (pre-illness) stage of psychosis. The present study utilized retrospective parent reports to examine total early childhood social communication deficits, as well as deficits in two distinct domains, reciprocal social interaction (social smiling/eye gaze) and communication (social chat/gesture), in youth at clinical high-risk (CHR) for psychosis (ages 13–21; 37.2% female). Furthermore, associations between early childhood social communication and CHR youth's current functioning (social, academic/work), symptoms (positive/negative), and risk for conversion to psychosis were examined. Compared to healthy controls, CHR individuals had greater deficits in total and communication-specific early childhood social communication. Early childhood total, communication, and reciprocal social interaction deficits were associated with worse current functioning and greater current negative symptom severity (amotivation/anhedonia) in CHR youth. Early childhood total and reciprocal social interaction deficits were also associated with increased risk for conversion. These findings inform the field's understanding of the etiology and pathophysiology of psychosis by extending the current developmental literature on premorbid deficits in psychosis populations to specific domains of social behavior in a critical developmental period.

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Patterns of premorbid functioning in individuals at clinical high risk of psychosis

Cited by 26 publications

References 22 publications

Characterization of children and adolescents with psychosis risk syndrome: The Children and Adolescents Psychosis Risk Syndrome (CAPRIS) study

Characterization of children and adolescents with psychosis risk syndrome: The Children and Adolescents Psychosis Risk Syndrome (CAPRIS) study

Cortical abnormalities in youth at clinical high-risk for psychosis: Findings from the NAPLS2 cohort

Early childhood social communication deficits in youth at clinical high-risk for psychosis: Associations with functioning and risk

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