Abstract
Cognitive dysfunction is a hallmark feature of schizophrenia and is evident across all phases of the illness. While prior metaanalyses have elucidated the level and pattern of cognitive deficits in the premorbid and post-onset periods of psychosis, no metaanalyses of studies of the putative prodromal period have been published. Our primary aim is to provide a meta-analysis of neurocognitive findings from 14 studies of psychosis risk syndrome (PRS) individuals published through February 2011, and compare the resulting profile with that synthesized by meta-analyses from other periods of the disorder. Meta-analysis of 1215 PRS individuals with a mean age of 19.2 (± 3.3) and 851 healthy control subjects yielded small-to-medium impairments across nine of 10 neurocognitive domains (Cohens d = -0.26 to -0.67). Seven studies reported on PRS individuals who later developed psychosis (n = 175) and their baseline performance level generally yielded moderate-to-large ESs (d = -0.35 to -0.84). Mild cognitive deficits are reliably and broadly present in PRS individuals, falling at a level that is intermediate between healthy individuals and those diagnosed with schizophrenia, and at a level that is comparable to those at familial (“genetic”) risk and with premorbid data. Moreover, baseline neurocognition in PRS individuals who converted to psychosis showed more severe deficits than non-converters in nearly all domains. However, considerable heterogeneity of ESs across studies in many domains underscores variability in phenotypic expression and/or measurement sensitivity, and a critical need for improved reporting of sample characteristics to support moderator variable analyses.
Keywords: Schizophrenia, psychosis, prodrome, clinical high risk, neurocognition, meta-analysis, psychosis risk syndrome (PRS), gray matter volume, cohort assessments, DSM-IV diagnoses
Current Pharmaceutical Design
Title: Neurocognition in the Psychosis Risk Syndrome: A Quantitative and Qualitative Review
Volume: 18 Issue: 4
Author(s): Anthony J. Giuliano, Huijun Li, Raquelle I. Mesholam-Gately, Shannon M. Sorenson, Kristen A. Woodberry and Larry J. Seidman
Affiliation:
Keywords: Schizophrenia, psychosis, prodrome, clinical high risk, neurocognition, meta-analysis, psychosis risk syndrome (PRS), gray matter volume, cohort assessments, DSM-IV diagnoses
Abstract: Cognitive dysfunction is a hallmark feature of schizophrenia and is evident across all phases of the illness. While prior metaanalyses have elucidated the level and pattern of cognitive deficits in the premorbid and post-onset periods of psychosis, no metaanalyses of studies of the putative prodromal period have been published. Our primary aim is to provide a meta-analysis of neurocognitive findings from 14 studies of psychosis risk syndrome (PRS) individuals published through February 2011, and compare the resulting profile with that synthesized by meta-analyses from other periods of the disorder. Meta-analysis of 1215 PRS individuals with a mean age of 19.2 (± 3.3) and 851 healthy control subjects yielded small-to-medium impairments across nine of 10 neurocognitive domains (Cohens d = -0.26 to -0.67). Seven studies reported on PRS individuals who later developed psychosis (n = 175) and their baseline performance level generally yielded moderate-to-large ESs (d = -0.35 to -0.84). Mild cognitive deficits are reliably and broadly present in PRS individuals, falling at a level that is intermediate between healthy individuals and those diagnosed with schizophrenia, and at a level that is comparable to those at familial (“genetic”) risk and with premorbid data. Moreover, baseline neurocognition in PRS individuals who converted to psychosis showed more severe deficits than non-converters in nearly all domains. However, considerable heterogeneity of ESs across studies in many domains underscores variability in phenotypic expression and/or measurement sensitivity, and a critical need for improved reporting of sample characteristics to support moderator variable analyses.
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Cite this article as:
J. Giuliano Anthony, Li Huijun, I. Mesholam-Gately Raquelle, M. Sorenson Shannon, A. Woodberry Kristen and J. Seidman Larry, Neurocognition in the Psychosis Risk Syndrome: A Quantitative and Qualitative Review, Current Pharmaceutical Design 2012; 18 (4) . https://dx.doi.org/10.2174/138161212799316019
DOI https://dx.doi.org/10.2174/138161212799316019 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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