Verbal memory performance predicts remission and functional outcome in people at clinical high-risk for psychosis

Hedges, Emily; Dickson, Hannah; Tognin, Stefania; Modinos, Gemma; Antoniades, Mathilde; Gaag, Mark van der; Haan, Lieuwe de; McGorry, Patrick D.; Pantelis, Christos; Riecher‐Rössler, Anita; Bressan, Rodrigo; Barrantes‐Vidal, Neus; Krebs, Marie‐Odile; Nordentoft, Merete; Ruhrmann, Stephan; Sachs, Gabriele; Rutten, Bart P. F.; Os, Jim van; Valmaggia, Lucia; McGuire, Philip; Kempton, Matthew J.

doi:10.1016/j.scog.2021.100222

Cited by 14 publications

(12 citation statements)

References 46 publications

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“…Robust deficits in neurocognition are evident in the early stages of psychosis development among people at clinical high-risk for psychosis (CHR) (Catalan et al, 2021 ; Hedges et al, 2022 ; Seidman et al, 2016 ). As these deficits are less pronounced than individuals with first-episode psychosis (FEP) compared to healthy control (HC) individuals (Sheffield, Karcher, & Barch, 2018 ), reviews indirectly comparing cross-sectional studies of FEP and CHR samples have suggested a potential neurocognitive decline prior to or over the transition to psychosis (Giuliano et al, 2012 ; Mesholam-Gately, Giuliano, Goff, Faraone, & Seidman, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of longitudinal neurocognitive performance in people at clinical high-risk for psychosis

Hedges

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et al. 2022

Psychol. Med.

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Persons at clinical high-risk for psychosis (CHR) are characterised by specific neurocognitive deficits. However, the course of neurocognitive performance during the prodromal period and over the onset of psychosis remains unclear. The aim of this meta-analysis was to synthesise results from follow-up studies of CHR individuals to examine longitudinal changes in neurocognitive performance. Three electronic databases were systematically searched to identify articles published up to 31 December 2021. Thirteen studies met inclusion criteria. Study effect sizes (Hedges' g) were calculated and pooled for each neurocognitive task using random-effects meta-analyses. We examined whether changes in performance between baseline and follow-up assessments differed between: (1) CHR and healthy control (HC) individuals, and (2) CHR who did (CHR-T) and did not transition to psychosis (CHR-NT). Meta-analyses found that HC individuals had greater improvements in performance over time compared to CHR for letter fluency (g = −0.32, p = 0.029) and digit span (g = −0.30, p = 0.011) tasks. Second, there were differences in longitudinal performance of CHR-T and CHR-NT in trail making test A (TMT-A) (g = 0.24, p = 0.014) and symbol coding (g = −0.51, p = 0.011). Whilst CHR-NT improved in performance on both tasks, CHR-T improved to a lesser extent in TMT-A and had worsened performance in symbol coding over time. Together, neurocognitive performance generally improved in all groups at follow-up. Yet, evidence suggested that improvements were less pronounced for an overall CHR group, and specifically for CHR-T, in processing speed tasks which may be a relevant domain for interventions aimed to enhance neurocognition in CHR populations.

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Section: Introductionmentioning

confidence: 99%

Meta-analysis of longitudinal neurocognitive performance in people at clinical high-risk for psychosis

Hedges

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et al. 2022

Psychol. Med.

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“…Yet others find impairment in attention, verbal learning and memory, working memory, verbal fluency and executive function, as well as a composite score in the at-risk group compared to healthy controls ( 17 ). There are, however, impairments in some specific domains that stand out in at-risk groups, such as verbal learning and memory ( 44 , 45 ). Verbal learning and memory have been found to be more strongly associated with a genetic vulnerability to psychosis than other cognitive domains ( 46 ).…”

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confidence: 99%

Cognitive functioning in a group of adolescents at risk for psychosis

et al. 2022

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Cognitive deficits are a core feature of schizophrenia, and impairments are present in groups at-risk for psychosis. Most at-risk studies include young adults and not younger age-groups, such as adolescents. Participants are usually help-seeking individuals, even though risk factors may also be present in non-help seeking adolescents. We aim to explore cognitive functions in a group of non-help-seeking 15-year-old adolescents at risk for psychosis compared to age- and gender matched controls, including particular focus on specific cognitive domains. Hundred participants (mean age = 15.3) were invited after completing the 14-year-old survey distributed by the Norwegian Mother-, Father- and Child Study. At-risk adolescents were selected based on high scores on 19 items assessing both psychotic experiences and anomalous self-experiences. Matched controls were selected from the same sample. Cognitive functioning was assessed using the MATRICS Consensus Cognitive Battery and IQ using Wechsler’s Abbreviated Test of Intelligence. We found that the adolescents at-risk for psychosis had significantly poorer scores than controls on the composite score of the MCCB. IQ scores were also significantly lower in the at-risk group. The results highlight general cognitive deficits as central in a group of non-help-seeking adolescents at-risk for psychosis. Results indicate that the development of cognitive impairments starts early in life in at-risk groups. It is still unclear whether specific cognitive domains, such as verbal learning, are related to psychotic symptoms or may be specifically vulnerable to symptoms of depression and anxiety.

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“…Level of functioning was assessed based on the GAF disability score, as in previous research. 22 White Noise Task. The WNT was used to assess the incidence of SIs heard in white noise 9,11,27,28 (figure 1).…”

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confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Within CHR participants, impaired performance across a range of different cognitive tasks has been associated with adverse outcomes, including transition to psychosis, [18][19][20][21] persistence of CHR symptoms, 22 and low functioning. 22 Whilst the perceived length of SI 23 has been linked to transition to psychosis, the incidence of SIs, and associated SDT parameters, have not been associated with clinical outcome. The second aim of this study was to assess whether within a CHR cohort the incidence of SIs or associated SDT parameters at baseline is associated with transition to psychosis, persistence of symptoms, or decreased functioning, 2 years later.…”

Section: Introductionmentioning

confidence: 99%

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Speech Illusions in People at Clinical High Risk for Psychosis Linked to Clinical Outcome

Hird

Ohmuro

Allen

et al. 2022

Schizophrenia Bulletin

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Background and hypothesis Around 20% of people at clinical high risk (CHR) for psychosis later develop a psychotic disorder, but it is difficult to predict who this will be. We assessed the incidence of hearing speech (termed speech illusions [SIs]) in noise in CHR participants and examined whether this was associated with adverse clinical outcomes. Study design At baseline, 344 CHR participants and 67 healthy controls were presented with a computerized white noise task and asked whether they heard speech, and whether speech was neutral, affective, or whether they were uncertain about its valence. After 2 years, we assessed whether participants transitioned to psychosis, or remitted from the CHR state, and their functioning. Study results CHR participants had a lower sensitivity to the task. Logistic regression revealed that a bias towards hearing targets in stimuli was associated with remission status (OR = 0.21, P = 042). Conversely, hearing SIs with uncertain valence at baseline was associated with reduced likelihood of remission (OR = 7.72. P = .007). When we assessed only participants who did not take antipsychotic medication at baseline, the association between hearing SIs with uncertain valence at baseline and remission likelihood remained (OR = 7.61, P = .043) and this variable was additionally associated with a greater likelihood of transition to psychosis (OR = 5.34, P = .029). Conclusions In CHR individuals, a tendency to hear speech in noise, and uncertainty about the affective valence of this speech, is associated with adverse outcomes. This task could be used in a battery of cognitive markers to stratify CHR participants according to subsequent outcomes.

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Verbal memory performance predicts remission and functional outcome in people at clinical high-risk for psychosis

Cited by 14 publications

References 46 publications

Meta-analysis of longitudinal neurocognitive performance in people at clinical high-risk for psychosis

Meta-analysis of longitudinal neurocognitive performance in people at clinical high-risk for psychosis

Cognitive functioning in a group of adolescents at risk for psychosis

Speech Illusions in People at Clinical High Risk for Psychosis Linked to Clinical Outcome

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