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Neuropsychological evidence for abnormal neurodevelopment associated with early-onset psychoses

Published online by Cambridge University Press:  25 July 2012

I. Bombin ,
M. Mayoral ,
J. Castro-Fornieles ,
A. Gonzalez-Pinto ,
E. de la Serna ,
M. Rapado-Castro ,
S. Barbeito ,
M. Parellada ,
I. Baeza  and
M. Graell
...Show all authors
I. Bombin*
Affiliation:
Department of Psychology, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain Department of Neuropsychology, Reintegra Foundation, Oviedo, Spain
M. Mayoral
Affiliation:
Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Madrid, Spain
J. Castro-Fornieles
Affiliation:
Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
A. Gonzalez-Pinto
Affiliation:
Stanley Institute International Mood-Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, CIBERSAM, EHU/UPV, Vitoria, Spain
E. de la Serna
Affiliation:
Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
M. Rapado-Castro
Affiliation:
Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Madrid, Spain
S. Barbeito
Affiliation:
Stanley Institute International Mood-Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, CIBERSAM, EHU/UPV, Vitoria, Spain
M. Parellada
Affiliation:
Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Madrid, Spain
I. Baeza
Affiliation:
Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
M. Graell
Affiliation:
Section of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
B. Payá
Affiliation:
Child and Adolescent Mental Health Unit, Department of Psychiatry and Psychology, Hospital Universitario Marqués de Valdecilla, CIBERSAM, Santander, Spain
C. Arango
Affiliation:
Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Madrid, Spain
*
*Address for correspondence: I. Bombin, Ph.D., Reintegra Foundation: Centro de Rehabilitación Neurológica, C/Eduardo de Fraga Torrejón, 4, bajo, Oviedo 33011, Spain. (Email: [email protected])
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Abstract

Background

The longitudinal neuropsychological study of first-episode early-onset psychosis (EOP) patients, whose brain maturation is still in progress at the time of illness onset, provides a unique opportunity to compare their cognitive development with that of healthy subjects, in search of specific patterns resulting from the interaction between neurodevelopmental processes and the presence of psychotic disorders.

Method

Seventy-five first-episode EOP patients (schizophrenia n = 35; bipolar disorder n = 17; other forms of psychosis n = 23) with a mean age of 15.53 years were assessed with a neuropsychological battery that included measures of attention, working memory, memory and executive functions within 6 months following the onset of the first psychotic symptom (baseline) and 2 years later. Psychotic symptoms were assessed at both times with the Positive and Negative Symptom Scale (PANSS). Seventy-nine healthy subjects matched for age and education served as controls.

Results

EOP patients showed significant cognitive impairment at both baseline and the 2-year follow-up, with no significant differences between diagnostic groups at either time. Both healthy controls and EOP patients improved in all cognitive measures, except for patient working memory. Improvement in patient attention lost significance after controlling for psychotic symptom reduction. No significant time/diagnosis interaction was found among patients (p > 0.405).

Conclusions

Cognitive impairment in EOP is already present at the first episode, and cognitive development seems to be arrested early in EOP patients compared to their healthy peers, at least for some cognitive functions. These and previous similar results support the neurodevelopmental hypothesis of psychosis.

Keywords

Cognitionlongitudinal designneurodevelopmental hypothesispsychosis
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 4 , April 2013 , pp. 757 - 768
Copyright
Copyright © Cambridge University Press 2012

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References

Addington, J, Addington, D (2002). Cognitive functioning in first-episode schizophrenia. Journal of Psychiatry and Neuroscience 27, 188–192.Google ScholarPubMed
Albus, M, Hubmann, W, Wahlheim, C, Sobizack, N, Franz, U, Mohr, F (1996). Contrasts in neuropsychological test profile between patients with first-episode schizophrenia and first-episode affective disorders. Acta Psychiatrica Scandinavica 94, 87–93.CrossRefGoogle ScholarPubMed
APA (1994). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association: Washington, DC.Google Scholar
Bilder, RM, Goldman, RS, Robinson, D, Reiter, G, Bell, L, Bates, JA, Pappadopulos, E, Willson, DF, Alvir, JM, Woerner, MG, Geisler, S, Kane, JM, Lieberman, JA (2000). Neuropsychology of first-episode schizophrenia: initial characterization and clinical correlates. American Journal of Psychiatry 157, 549–559.CrossRefGoogle ScholarPubMed
Bora, E, Yücel, M, Pantelis, C (2010). Cognitive impairment in schizophrenia and affective psychoses: implications for DSM-V criteria and beyond. Schizophrenia Bulletin 36, 36–42.CrossRefGoogle ScholarPubMed
Brickman, AM, Buchsbaum, MS, Bloom, R, Bokhoven, P, Paul-Odouard, R, Haznedar, MM, Dahlman, KL, Hazlett, EA, Aronowitz, J, Heath, D, Shihabuddin, L (2004). Neuropsychological functioning in first-break, never-medicated adolescents with psychosis. Journal of Nervous and Mental Disease 192, 615–622.CrossRefGoogle ScholarPubMed
Buchanan, RW, Davis, M, Goff, D, Green, MF, Keefe, RS, Leon, AC, Nuechterlein, KH, Laughren, T, Levin, R, Stover, E, Fenton, W, Marder, SR (2005). A summary of the FDA-NIMH-MATRICS workshop on clinical trial design for neurocognitive drugs for schizophrenia. Schizophrenia Bulletin 31, 5–19.CrossRefGoogle ScholarPubMed
Cannon, M, Caspi, A, Moffitt, TE, Harrington, H, Taylor, A, Murray, RM, Poulton, R (2002). Evidence for early-childhood, pan-developmental impairment specific to schizophreniform disorder: results from a longitudinal birth cohort. Archives of General Psychiatry 59, 449–456.CrossRefGoogle ScholarPubMed
Cannon, TD, Bearden, CE, Hollister, JM, Rosso, IM, Sanchez, LE, Hadley, T (2000). Childhood cognitive functioning in schizophrenia patients and their unaffected siblings: a prospective cohort study. Schizophrenia Bulletin 26, 379–393.CrossRefGoogle ScholarPubMed
Cannon-Spoor, HE, Potkin, SG, Wyatt, RJ (1982), Measurement of premorbid adjustment in chronic schizophrenia. Schizophrenia Bulletin 26, 351–366.Google Scholar
Caspi, A, Reichenberg, A, Weiser, M, Rabinowitz, J, Kaplan, Z, Knobler, H, Davidson-Sagi, N, Davidson, M (2003). Cognitive performance in schizophrenia patients assessed before and following the first psychotic episode. Schizophrenia Research 65, 87–94.CrossRefGoogle ScholarPubMed
Castro-Fornieles, J, Parellada, M, Gonzalez-Pinto, A, Moreno, D, Graell, M, Baeza, I, Otero, S, Soutullo, CA, Crespo-Facorro, B, Ruiz-Sancho, A, Desco, M, Rojas-Corrales, O, Patino, A, Carrasco-Marin, E, Arango, C (2007). The child and adolescent first-episode psychosis study (CAFEPS): design and baseline results. Schizophrenia Research 91, 226–237.CrossRefGoogle ScholarPubMed
Daban, C, Amado, I, Bayle, F, Gut, A, Willard, D, Bourdel, MC, Loo, H, Olie, JP, Millet, B, Krebs, MO, Poirier, MF (2002). Correlation between clinical syndromes and neuropsychological tasks in unmedicated patients with recent onset schizophrenia. Psychiatry Research 113, 83–92.CrossRefGoogle ScholarPubMed
Fitzgerald, D, Lucas, S, Redoblado, MA, Winter, V, Brennan, J, Anderson, J, Harris, A (2004). Cognitive functioning in young people with first episode psychosis: relationship to diagnosis and clinical characteristics. Australian and New Zealand Journal of Psychiatry 38, 501–510.CrossRefGoogle ScholarPubMed
Frangou, S, Hadjulis, M, Vourdas, A (2008). The Maudsley early onset schizophrenia study: cognitive function over a 4-year follow-up period. Schizophrenia Bulletin 34, 52–59.CrossRefGoogle Scholar
Fuller, R, Nopoulos, P, Arndt, S, O'Leary, D, Ho, BC, Andreasen, NC (2002). Longitudinal assessment of premorbid cognitive functioning in patients with schizophrenia through examination of standardized scholastic test performance. American Journal of Psychiatry 159, 1183–1189.CrossRefGoogle ScholarPubMed
Goldberg, TE, Keefe, RS, Goldman, RS, Robinson, DG, Harvey, PD (2010). Circumstances under which practice does not make perfect: a review of the practice effect literature in schizophrenia and its relevance to clinical treatment studies. Neuropsychopharmacology 35, 1053–1062.CrossRefGoogle Scholar
Heaton, RK, Gladsjo, JA, Palmer, BW, Kuck, J, Marcotte, TD, Jeste, DV (2001). Stability and course of neuropsychological deficits in schizophrenia. Archives of General Psychiatry 58, 24–32.CrossRefGoogle ScholarPubMed
Heinrichs, RW, Zakzanis, KK (1998). Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 12, 426–445.CrossRefGoogle ScholarPubMed
Hill, SK, Schuepbach, D, Herbener, ES, Keshavan, MS, Sweeney, JA (2004). Pretreatment and longitudinal studies of neuropsychological deficits in antipsychotic-naive patients with schizophrenia. Schizophrenia Research 68, 49–63.CrossRefGoogle ScholarPubMed
Hoff, AL, Sakuma, M, Wieneke, M, Horon, R, Kushner, M, DeLisi, LE (1999). Longitudinal neuropsychological follow-up study of patients with first-episode schizophrenia. American Journal of Psychiatry 156, 1336–1341.CrossRefGoogle ScholarPubMed
Ismail, B, Cantor-Graae, E, McNeil, TF (2000). Minor physical anomalies in schizophrenia: cognitive, neurological and other clinical correlates. Journal of Psychiatric Research 34, 45–56.CrossRefGoogle ScholarPubMed
Janca, A, Kastrup, M, Katschnig, H, Lopez-Ibor, Jr. JJ, Mezzich, JE (1996). The World Health Organization Short Disability Assessment Schedule (WHO DAS-S): a tool for the assessment of difficulties in selected areas of functioning of patients with mental disorders. Social Psychiatry and Psychiatric Epidemiology 31, 349–359.CrossRefGoogle Scholar
Kaufman, J, Birmaher, B, Brent, D, Rao, U, Ryan, N (1996). The Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version (version 1.0). Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.Google Scholar
Kravariti, E, Morris, RG, Rabe-Hesketh, S, Murray, RM, Frangou, S (2003). The Maudsley Early-Onset Schizophrenia Study: cognitive function in adolescent-onset schizophrenia. Schizophrenia Research 65, 95–103.CrossRefGoogle ScholarPubMed
Kremen, WS, Buka, SL, Seidman, LJ, Goldstein, JM, Koren, D, Tsuang, MT (1998). IQ decline during childhood and adult psychotic symptoms in a community sample: a 19-year longitudinal study. American Journal of Psychiatry 155, 672–677.CrossRefGoogle Scholar
Lewandowski, KE, Cohen, BM, Ongur, D (2011). Evolution of neuropsychological dysfunction during the course of schizophrenia and bipolar disorder. Psychological Medicine 41, 225–241.CrossRefGoogle ScholarPubMed
Lewis, DA, Levitt, P (2002). Schizophrenia as a disorder of neurodevelopment. Annual Review of Neuroscience 25, 409–432.CrossRefGoogle ScholarPubMed
Luna, B, Thulborn, KR, Munoz, DP, Merriam, EP, Garver, KE, Minshew, NJ, Keshavan, MS, Genovese, CR, Eddy, WF, Sweeney, JA (2001). Maturation of widely distributed brain function subserves cognitive development. NeuroImage 13, 786–793.CrossRefGoogle ScholarPubMed
Martinez-Aran, A, Vieta, E, Reinares, M, Colom, F, Torrent, C, Sanchez-Moreno, J, Benabarre, A, Goikolea, JM, Comes, M, Salamero, M (2004). Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. American Journal of Psychiatry 161, 262–270.CrossRefGoogle ScholarPubMed
Mayoral, M, Zabala, A, Robles, O, Bombin, I, Andres, P, Parellada, M, Moreno, D, Graell, M, Medina, O, Arango, C (2008). Neuropsychological functioning in adolescents with first episode psychosis: a two-year follow-up study. European Psychiatry 23, 375–383.CrossRefGoogle ScholarPubMed
Marín, O (2012). Interneuron dysfunction in psychiatric disorders. Nature Reviews Neuroscience 8, 107–120.CrossRefGoogle Scholar
Osuji, IJ, Cullum, CM (2005). Cognition in bipolar disorder. Psychiatric Clinics of North America 28, 427–441.CrossRefGoogle ScholarPubMed
Peralta, V, Cuesta, MJ (1994). Psychometric properties of the positive and negative syndrome scale (PANSS) in schizophrenia. Psychiatry Research 53, 31–40.CrossRefGoogle ScholarPubMed
Quraishi, S, Frangou, S (2002). Neuropsychology of bipolar disorder: a review. Journal of Affective Disorders 72, 209–226.CrossRefGoogle ScholarPubMed
Reichenberg, A, Caspi, A, Harrington, H, Houts, R, Keefe, RS, Murray, RM, Poulton, R, Moffitt, TE (2009). Static and dynamic cognitive deficits in childhood preceding adult schizophrenia: a 30-year study. American Journal of Psychiatry 167, 160–169.CrossRefGoogle Scholar
Rosa, A, Fananas, L, Bracha, HS, Torrey, EF, van Os, J (2000). Congenital dermatoglyphic malformations and psychosis: a twin study. American Journal of Psychiatry 157, 1511–1513.CrossRefGoogle ScholarPubMed
Sanches, M, Keshavan, MS, Brambilla, P, Soares, JC (2008). Neurodevelopmental basis of bipolar disorder: a critical appraisal. Progress in Neuro-Psychopharmacology and Biological Psychiatry 32, 1617–1627.CrossRefGoogle ScholarPubMed
Sanchez-Morla, EM, Barabash, A, Martinez-Vizcaino, V, Tabares-Seisdedos, R, Balanza-Martinez, V, Cabranes-Diaz, JA, Baca-Baldomero, E, Gomez, JL (2009). Comparative study of neurocognitive function in euthymic bipolar patients and stabilized schizophrenic patients. Psychiatry Research 169, 220–228.CrossRefGoogle ScholarPubMed
Sattler, JM, Ryan, JJ (2001). Wechsler Adult Intelligence Scale–III: Description. In Assessment of Children: Cognitive Applications, 4th edn (ed. Sattler, J. M.), pp. 409–411. Jerome M. Sattler, Publisher, Inc.: San Diego, CA.Google Scholar
Schubert, EW, McNeil, TF (2004). Prospective study of neurological abnormalities in offspring of women with psychosis: birth to adulthood. American Journal of Psychiatry 161, 1030–1037.CrossRefGoogle ScholarPubMed
Sweeney, JA, Haas, GL, Keilp, JG, Long, M (1991). Evaluation of the stability of neuropsychological functioning after acute episodes of schizophrenia: one-year followup study. Psychiatry Research 38, 63–76.CrossRefGoogle ScholarPubMed
Szoke, A, Trandafir, A, Dupont, ME, Meary, A, Schurhoff, F, Leboyer, M (2008). Longitudinal studies of cognition in schizophrenia: meta-analysis. British Journal of Psychiatry 192, 248–257.CrossRefGoogle ScholarPubMed
Waber, DP, De Moor, C, Forbes, PW, Almli, CR, Botteron, KN, Leonard, G, Milovan, D, Paus, T, Rumsey, J (2007). The NIH MRI study of normal brain development: performance of a population based sample of healthy children aged 6 to 18 years on a neuropsychological battery. Journal of the International Neuropsychological Society 13, 729–746.CrossRefGoogle ScholarPubMed
Walker, EF, Diforio, D, Baum, K (1999). Developmental neuropathology and the precursors of schizophrenia. Acta Psychiatrica Scandinavica. Supplementum 395, 12–19.CrossRefGoogle ScholarPubMed
Walker, EF, Savoie, T, Davis, D (1994). Neuromotor precursors of schizophrenia. Schizophrenia Bulletin 20, 441–451.CrossRefGoogle ScholarPubMed
Wechsler, D (1974). Manual of the Wechsler Intelligence Scale for Children – Revised. Psychological Corporation: New York. Spanish adaptation (2001) TEA Ediciones: Madrid.Google Scholar
Wechsler, D (1997). Wechsler Adult Intelligence Scale, 3rd edition (WAIS-III). Administration and Scoring Manual. Psychological Corporation: San Antonio, TX. Spanish adaptation (1999) TEA Ediciones: Madrid.Google Scholar
Weinberger, DR (1987). Implications of normal brain development for the pathogenesis of schizophrenia. Archives of General Psychiatry 44, 660–669.CrossRefGoogle ScholarPubMed
Welham, J, Isohanni, M, Jones, P, McGrath, J (2009). The antecedents of schizophrenia: a review of birth cohort studies. Schizophrenia Bulletin 35, 603–623.CrossRefGoogle ScholarPubMed
Zabala, A, Rapado, M, Arango, C, Robles, O, de la Serna, E, Gonzalez, C, Rodriguez-Sanchez, JM, Andres, P, Mayoral, M, Bombin, I (2010). Neuropsychological functioning in early-onset first-episode psychosis: comparison of diagnostic subgroups. European Archives of Psychiatry and Clinical Neuroscience 260, 225–233.CrossRefGoogle ScholarPubMed