Hostname: page-component-745bb68f8f-b6zl4 Total loading time: 0 Render date: 2025-01-08T22:30:46.732Z Has data issue: false hasContentIssue false
  • English
  • Français

Neurocognitive functioning before and after the first psychotic episode: does psychosis result in cognitive deterioration?

Published online by Cambridge University Press:  05 February 2010

H. E. Becker ,
D. H. Nieman ,
S. Wiltink ,
P. M. Dingemans ,
J. R. van de Fliert ,
E. Velthorst ,
L. de Haan ,
T. A. van Amelsvoort  and
D. H. Linszen
H. E. Becker*
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
D. H. Nieman
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
S. Wiltink
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
P. M. Dingemans
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
J. R. van de Fliert
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
E. Velthorst
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
L. de Haan
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
T. A. van Amelsvoort
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
D. H. Linszen
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
*
*Address for correspondence: H. E. Becker, M.D., Academic Medical Centre, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Cognitive impairment is considered to be a core characteristic of schizophrenia. The relationship between psychosis and cognitive deterioration, however, remains unclear. This longitudinal study investigated the neuropsychological functioning of patients before and after their first psychotic episode. Cognitive functioning of participants who later developed a psychosis was compared to that of people at ultra-high risk (UHR) for psychosis who did not develop psychosis at follow-up and healthy controls.

Method

Participants were 41 persons at UHR for psychosis (the UHR group), of whom 17 developed psychosis between the first and second assessment. Seventeen healthy controls were included in the study. Cognitive performance was assessed at intake (T0) and again after 18 months (T1). The areas of cognitive functioning assessed include verbal memory and learning, visuospatial working memory, executive function, sustained attention and motor speed.

Results

The transition group did not perform significantly worse at the second assessment than at the first on any of the outcome measures. The UHR group performed better on a verbal learning and memory test at T1 compared to T0. At T0, the control group scored significantly better than the UHR group and the transition group on the verbal learning and memory test and the verbal fluency test.

Conclusions

The results indicate that no cognitive deterioration occurs during the first psychotic episode. Problems in verbal memory may be present before the first episode of psychosis.

Keywords

Neuropsychologypsychosisprodromalultra-high risk
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 10 , October 2010 , pp. 1599 - 1606
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adjutant General's Office (1944). Army Individual Test. Manual of Directions and Scoring. Washington DC: War Department.Google Scholar
Addington, J, Addington, D (2002). Cognitive functioning in first-episode schizophrenia. Journal of Psychiatry Neuroscience 27, 188–192.Google ScholarPubMed
Amminger, GP, Edwards, J, Brewer, WJ, Harrigan, S, McGorry, PD (2002). Duration of untreated psychosis and cognitive deterioration in first-episode schizophrenia. Schizophrenia Research 54, 223–230.CrossRefGoogle ScholarPubMed
Andreasen, N, Paradiso, S, O'Leary, D (1998). ‘Cognitive dysmetria’ as an integrative theory of schizophrenia: a dysfunction in cortical-subcortical-cerebellar circuitry? Schizophrenia Bulletin 24, 203–218.CrossRefGoogle ScholarPubMed
Andrews, G, Peters, L (1998). The psychometric properties of the Composite International Diagnostic Interview. Social Psychiatry and Psychiatric Epidemiology 33, 80–88.CrossRefGoogle ScholarPubMed
Barnes, TR, Hutton, SB, Chapman, MJ, Mutsatsa, S, Puri, BK, Joyce, EM (2000). West London first-episode study of schizophrenia. Clinical correlates of duration of untreated psychosis. British Journal of Psychiatry 177, 207–211.CrossRefGoogle ScholarPubMed
Borgwardt, SJ, McGuire, PK, Aston, J, Berger, G, Dazzan, P, Gschwandner, U, Pfluger, M, D'Souza, M, Radue, EW, Riecher-Rossler, A (2007). Structural brain abnormalities in individuals with an at-risk mental state who later develop psychosis. British Journal of Psychiatry 51, 69–75.CrossRefGoogle ScholarPubMed
Brewer, WJ, Francey, SM, Wood, SJ, Jackson, HJ, Pantelis, C, Phillips, LJ, Yung, AR, Anderson, VA, McGorry, PD (2005). Memory impairments identified in people at ultra-high risk for psychosis who later develop first-episode psychosis. American Journal of Psychiatry 162, 71–78.CrossRefGoogle ScholarPubMed
Cosway, R, Byrne, M, Clafferty, R, Hodges, A, Grant, E, Abukmeil, SS, Lawrie, SM, Miller, P, Johnstone, EC (2000). Neuropsychological change in young people at high risk for schizophrenia: results from the first two neuropsychological assessments of the Edinburgh High Risk Study. Psychological Medicine 30, 1111–1121.CrossRefGoogle ScholarPubMed
Crow, TJ, Done, DJ, Sacker, A (1995). Childhood precursors of psychosis as clues to its evolutionary origins. European Archives of Psychiatry and Clinical Neuroscience 245, 61–69.CrossRefGoogle ScholarPubMed
Eastvold, AD, Heaton, RK, Cadenhead, KS (2007). Neurocognitive deficits in the (putative) prodrome and first episode of psychosis. Schizophrenia Research 93, 266–277.CrossRefGoogle ScholarPubMed
Egan, MF, Goldberg, TE, Gscheidle, T, Weirich, M, Bigelow, LB, Weinberger, DR (2000). Relative risk of attention deficits in siblings of patients with schizophrenia. American Journal of Psychiatry 157, 1309–1316.CrossRefGoogle ScholarPubMed
Hawkins, KA, Keefe, RS, Christensen, BK, Addington, J, Woods, SW, Callahan, J, Zipursky, RB, Perkins, DO, Tohen, M, Breier, A, McGlashan, TH (2008). Neuropsychological course in the prodrome and first episode of psychosis: findings from the PRIME North America Double Blind Treatment Study. Schizophrenia Research 105, 1–9.CrossRefGoogle ScholarPubMed
Heinrichs, RW, Zakzanis, KK (1998). Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 12, 426–445.CrossRefGoogle ScholarPubMed
Isohanni, M, Jones, P, Moilanen, K, Veijola, J, Oja, H, Koiranen, M, Jokelainen, J, Croudace, T, Jarvelin, MR (2001). Early developmental milestones in adult schizophrenia and other psychoses. A 31-year follow-up of the North Finland 1966 Birth Cohort. Schizophrenia Research 52, 1–19.CrossRefGoogle Scholar
Isohanni, M, Murray, GK, Jokelainen, J, Croudace, T, Jones, PB (2004). The persistence of developmental markers in childhood and adolescence and risk for schizophrenic psychoses in adult life. A 34-year follow-up of the Northern Finland 1966 birth cohort. Schizophrenia Research 71, 213–225.CrossRefGoogle ScholarPubMed
Joyce, EM, Hutton, SB, Mutsatsa, SH, Barnes, TRE (2005). Cognitive heterogeneity in first-episode schizophrenia. British Journal of Psychiatry 187, 516–522.CrossRefGoogle ScholarPubMed
Keefe, RS, Perkins, DO, Gu, H, Zipursky, RB, Christensen, BK, Lieberman, JA (2006). A longitudinal study of neurocognitive function in individuals at-risk for psychosis. Schizophrenia Research 88, 26–35.CrossRefGoogle ScholarPubMed
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. Schizophrenia Research 17, 25–33.CrossRefGoogle ScholarPubMed
Kibby, MY, Schmitter-Edgecombe, M, Long, CJ (1998). Ecological validity of neuropsychological tests: focus on the California Verbal Learning Test and the Wisconsin Card Sorting Test. Archives of Clinical Neuropsychology 13, 523–534.Google ScholarPubMed
Klosterkötter, J, Ruhrmann, S, Schultze-Lutter, F, Salokangas, RKR, Linszen, DH, Birchwood, M, Juckel, G, Morrison, A, Vazquez-Barquero, JL, Hambrecht, M, von Reventlow, H (2005). The European Prediction of Psychosis Study (EPOS): integrating early recognition and intervention in Europe. World Psychiatry 4, 161–167.Google ScholarPubMed
Kurtz, MM (2005). Neurocognitive impairment across the lifespan in schizophrenia: an update. Schizophrenia Research 74, 15–26.CrossRefGoogle ScholarPubMed
Lencz, T, Smith, CW, McLaughlin, D, Auther, A, Nakayama, E, Hovey, L, Cornblatt, BA (2006). Generalized and specific neurocognitive deficits in prodromal schizophrenia. Biological Psychiatry 59, 863–871.CrossRefGoogle ScholarPubMed
Lezak, MD (1995). Neuropsychological Assessment. Oxford University Press: New York.Google Scholar
McNeil, TF, Cantor-Graae, E (2000). Neuromotor markers of risk of schizophrenia. Australian and New Zealand Journal of Psychiatry 34, 86–90.CrossRefGoogle Scholar
Miller, J, McGlashan, TH, Rosen, JL, Somjee, L, Markovich, PJ, Stein, K, Woods, SW (2002). Prospective diagnosis of the initial prodrome for schizophrenia based on the Structured Interview for Prodromal Syndromes: preliminary evidence of interrater reliability and predictive validity. American Journal of Psychiatry 159, 863–865.CrossRefGoogle ScholarPubMed
Morey, RA, Inan, S, Mitchell, TV, Perkins, DO, Liebermann, JA, Belger, A (2005). Imaging frontostriatal function in ultra-high-risk, early and chronic schizophrenia during executive processing. Archives of General Psychiatry 62, 254–262.CrossRefGoogle ScholarPubMed
Nelson, HE, O'Connell, A (1978). Dementia: the estimation of premorbid intelligence levels using the New Adult Reading Test. Cortex 14, 234–244.CrossRefGoogle ScholarPubMed
Niendam, TA, Bearden, CE, Johnson, JK, McKinley, M, Loewy, R, O'Brien, M, Nuechterlein, KH, Green, MF, Cannon, TD (2006). Neurocognitive performance and functional disability in the psychosis prodrome. Schizophrenia Research 84, 100–111.CrossRefGoogle ScholarPubMed
Pantelis, C, Velakoulis, D, McGorry, PD, Wood, SJ, Suckling, J, Phillips, L, Yung, AR, Bullmore, ET, Brewer, W, Soulsby, B, Desmond, P, McGuire, PK (2003). Neuroanatomical abnormalities before and after the onset of psychosis: a cross-sectional and longitudinal MRI comparison. Lancet 361, 773–783.CrossRefGoogle ScholarPubMed
Riley, EM, McGovern, D, Mockler, D, Doku, VC, O'Ceallaigh, S, Fannon, DG, Tennakoon, L, Santamaria, M, Soni, W, Morris, RG, Sharma, T (2000). Neuropsychological functioning in first-episode psychosis – evidence of specific deficits. Schizophrenia Research 43, 47–55.CrossRefGoogle ScholarPubMed
Rund, BR, Melle, I, Friis, S, Larsen, TK, Midboe, LJ, Opsjordsmoen, S, Simonsen, E, Vaglum, P, McGlashan, T (2004). Neurocognitive dysfunction in first-episode psychosis: correlates with symptoms, premorbid adjustment, and duration of untreated psychosis. American Journal of Psychiatry 161, 466–472.CrossRefGoogle ScholarPubMed
Schmand, B, Lindeboom, J, Van Harskamp, F (1992). The Dutch Adult Reading Test [in Dutch]. Swets and Zeitlinger: Lisse, The Netherlands.Google Scholar
Scully, PJ, Coakley, G, Kinsella, A, Waddington, JL (1997). Psychopathology, executive (frontal) and general cognitive impairment in relation to duration of initially untreated versus subsequently treated psychosis in chronic schizophrenia. Psychological Medicine 27, 1303–1310.CrossRefGoogle ScholarPubMed
Shin, MS, Park, SY, Park, SR, Seol, SH, Kwon, SJ (2006). Clinical and empirical applications of the Rey–Osterrieth Complex Figure Test. Nature Protocols 1, 892–899.CrossRefGoogle ScholarPubMed
Simon, AE, Cattapan-Ludewig, K, Zmilacher, S, Arbach, D, Gruber, K, Dvorsky, DN, Roth, B, Isler, E, Zimmer, A, Umbricht, D (2007). Cognitive functioning in the schizophrenia prodrome. Schizophrenia Bulletin 33, 761–771.CrossRefGoogle ScholarPubMed
Spitzer, RL, Williams, JB, Gibbon, M, First, MB (1992). The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. Archives of General Psychiatry 49, 624–629.CrossRefGoogle ScholarPubMed
Wood, SJ, Brewer, WJ, Koutsouradis, P, Philips, LJ, Francey, SM, Proffitt, TM, Yung, AR, Jackson, HJ, McGorry, PD, Pantelis, C (2007). Cognitive decline following psychosis onset. Data from the PACE clinic. British Journal of Psychiatry 191 (Suppl. 51), 52–57.CrossRefGoogle Scholar
Wood, SJ, Pantelis, C, Proffitt, T, Phillips, LT, Stuart, GW, Buchanan, JA, Mahony, K, Brewer, W, Smith, DJ, McGorry, PD (2003). Spatial working memory ability is a marker of risk for psychosis. Psychological Medicine 33, 1239–1247.CrossRefGoogle ScholarPubMed
Woodberry, KA, Giuliano, AJ, Seidman, LJ (2008). Premorbid IQ in schizophrenia: a meta-analytic review. American Journal of Psychiatry 165, 579–587.CrossRefGoogle ScholarPubMed