Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings.
Journal
Molecular psychiatry
ISSN: 1476-5578
Titre abrégé: Mol Psychiatry
Pays: England
ID NLM: 9607835
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
19
08
2020
accepted:
18
11
2020
revised:
03
11
2020
pubmed:
9
1
2021
medline:
28
1
2022
entrez:
8
1
2021
Statut:
ppublish
Résumé
Important questions remain about the profile of cognitive impairment in psychotic disorders across adulthood and illness stages. The age-associated profile of familial impairments also remains unclear, as well as the effect of factors, such as symptoms, functioning, and medication. Using cross-sectional data from the EU-GEI and GROUP studies, comprising 8455 participants aged 18 to 65, we examined cognitive functioning across adulthood in patients with psychotic disorders (n = 2883), and their unaffected siblings (n = 2271), compared to controls (n = 3301). An abbreviated WAIS-III measured verbal knowledge, working memory, visuospatial processing, processing speed, and IQ. Patients showed medium to large deficits across all functions (ES range = -0.45 to -0.73, p < 0.001), while siblings showed small deficits on IQ, verbal knowledge, and working memory (ES = -0.14 to -0.33, p < 0.001). Magnitude of impairment was not associated with participant age, such that the size of impairment in older and younger patients did not significantly differ. However, first-episode patients performed worse than prodromal patients (ES range = -0.88 to -0.60, p < 0.001). Adjusting for cannabis use, symptom severity, and global functioning attenuated impairments in siblings, while deficits in patients remained statistically significant, albeit reduced by half (ES range = -0.13 to -0.38, p < 0.01). Antipsychotic medication also accounted for around half of the impairment in patients (ES range = -0.21 to -0.43, p < 0.01). Deficits in verbal knowledge, and working memory may specifically index familial, i.e., shared genetic and/or shared environmental, liability for psychotic disorders. Nevertheless, potentially modifiable illness-related factors account for a significant portion of the cognitive impairment in psychotic disorders.
Identifiants
pubmed: 33414498
doi: 10.1038/s41380-020-00969-z
pii: 10.1038/s41380-020-00969-z
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
4529-4543Subventions
Organisme : Medical Research Council
ID : MR/J008915/1
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom
Investigateurs
Maria Calem
(M)
Stefania Tognin
(S)
Gemma Modinos
(G)
Sara Pisani
(S)
Tamar C Kraan
(TC)
Daniella S van Dam
(DS)
Nadine Burger
(N)
G Paul Amminger
(GP)
Athena Politis
(A)
Joanne Goodall
(J)
Stefan Borgwardt
(S)
Erich Studerus
(E)
Ary Gadelha
(A)
Elisa Brietzke
(E)
Graccielle Asevedo
(G)
Elson Asevedo
(E)
Andre Zugman
(A)
Tecelli Domínguez-Martínez
(T)
Manel Monsonet
(M)
Paula Cristóbal-Narváez
(P)
Anna Racioppi
(A)
Thomas R Kwapil
(TR)
Mathilde Kazes
(M)
Claire Daban
(C)
Julie Bourgin
(J)
Olivier Gay
(O)
Célia Mam-Lam-Fook
(C)
Dorte Nordholm
(D)
Lasse Rander
(L)
Kristine Krakauer
(K)
Louise Birkedal Glenthøj
(LB)
Birte Glenthøj
(B)
Dominika Gebhard
(D)
Julia Arnhold
(J)
Joachim Klosterkötter
(J)
Iris Lasser
(I)
Bernadette Winklbaur
(B)
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Limited.
Références
Kahn RS, Keefe RS. Schizophrenia is a cognitive illness: time for a change in focus. JAMA Psy. 2013;70:1107–12.
Elvevag B, Goldberg TE. Cognitive impairment in schizophrenia is the core of the disorder. Critical Rev Neurobiol. 2000;14:1–21.
doi: 10.1615/CritRevNeurobiol.v14.i1.10
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Washington, D.C.: American Psychiatric Association; 2013.
World Health Organization. International classification of diseases, 11th revision (ICD-11). ICD-11 is here Geneva: World Health Organization; 2018.
Becker H, Nieman D, Wiltink S, Dingemans P, Van de Fliert J, Velthorst E, et al. Neurocognitive functioning before and after the first psychotic episode: does psychosis result in cognitive deterioration? Psych Med. 2010;40:1599–606.
doi: 10.1017/S0033291710000048
Mollon J, Mathias SR, Knowles EE, Rodrigue A, Koenis MM, Pearlson GD, et al. Cognitive impairment from early to middle adulthood in patients with affective and nonaffective psychotic disorders. Psychol Med. 2019;50:48–57.
pubmed: 30606277
pmcid: 7086288
doi: 10.1017/S0033291718003938
Bozikas VP, Andreou C. Longitudinal studies of cognition in first episode psychosis: a systematic review of the literature. Aust NZealand J Psych. 2011;45:93–108.
doi: 10.3109/00048674.2010.541418
Zanelli J, Mollon J, Sandin S, Morgan C, Dazzan P, Pilecka I, et al. Cognitive change in schizophrenia and other psychoses in the decade following the first episode. Am J Psychiatry. 2019;176:811–9.
pubmed: 31256609
doi: 10.1176/appi.ajp.2019.18091088
Harvey PD. What is the evidence for changes in cognition and functioning over the lifespan in patients with schizophrenia? J Clin Psychiatry. 2014;75:34–38.
pubmed: 24919170
doi: 10.4088/JCP.13065su1.08
Kodesh A, Goldberg Y, Rotstein A, Weinstein G, Reichenberg A, Sandin S, et al. Risk of dementia and death in very-late-onset schizophrenia-like psychosis: a national cohort study. Schizophrenia Res. 2020;223:220–6.
doi: 10.1016/j.schres.2020.07.020
Mollon J, David AS, Zammit S, Lewis G, Reichenberg A. Course of cognitive development from infancy to early adulthood in the psychosis spectrum. JAMA Psychiatry. 2018;75:270–9.
pubmed: 29387877
pmcid: 5885954
doi: 10.1001/jamapsychiatry.2017.4327
Reichenberg A, Caspi A, Harrington H, Houts R, Keefe RS, Murray RM, et al. Static and dynamic cognitive deficits in childhood preceding adult schizophrenia: a 30-year study. Am J Psyc. 2010;167:160–9.
doi: 10.1176/appi.ajp.2009.09040574
Lebel C, Walker L, Leemans A, Phillips L, Beaulieu C. Microstructural maturation of the human brain from childhood to adulthood. Neuroimage. 2008;40:1044–55.
pubmed: 18295509
doi: 10.1016/j.neuroimage.2007.12.053
Snitz BE, MacDonald III AW, Carter CS. Cognitive deficits in unaffected first-degree relatives of schizophrenia patients: a meta-analytic review of putative endophenotypes. Schizophr Bull. 2005;32:179–94.
pubmed: 16166612
doi: 10.1093/schbul/sbi048
Agnew-Blais J, Seidman LJ. Neurocognition in youth and young adults under age 30 at familial risk for schizophrenia: a quantitative and qualitative review. Cogn Neuropsychiatry. 2013;18:44–82.
pubmed: 22998599
doi: 10.1080/13546805.2012.676309
van Os J, van der Steen Y, Islam MA, Guloksuz S, Rutten BP, Simons CJ, et al. Evidence that polygenic risk for psychotic disorder is expressed in the domain of neurodevelopment, emotion regulation and attribution of salience. Psychol Med. 2017;47:2421–37.
pubmed: 28436345
doi: 10.1017/S0033291717000915
Sorensen HJ, Debost JC, Agerbo E, Benros ME, McGrath JJ, Mortensen PB, et al. Polygenic risk scores, school achievement, and risk for schizophrenia: a danish population-based study. Biol Psychiatry. 2018;84:684–91.
pubmed: 29807621
doi: 10.1016/j.biopsych.2018.04.012
Kuepper R, van Os J, Lieb R, Wittchen H-U, Höfler M, Henquet C. Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study. Bmj. 2011;342:d738.
pubmed: 21363868
pmcid: 3047001
doi: 10.1136/bmj.d738
EU-GEI. Identifying gene-environment interactions in schizophrenia: contemporary challenges for integrated, large-scale investigations. Schizophrenia Bulletin. 2014;40:729–36.
doi: 10.1093/schbul/sbu069
Gayer-Anderson C, Jongsma HE, Di Forti M, Quattrone D, Velthorst E, de Haan L, et al. The EUropean Network of National Schizophrenia networks studying gene–environment interactions (EU-GEI): incidence and first-episode case–control programme. Social Psych Psych Epidemiol. 2020:55:645–57.
doi: 10.1007/s00127-020-01831-x
Korver N, Quee PJ, Boos HB, Simons CJ, de Haan L, Investigators G. Genetic Risk and Outcome of Psychosis (GROUP), a multi site longitudinal cohort study focused on gene–environment interaction: objectives, sample characteristics, recruitment and assessment methods. Int J Methods Psych Res. 2012;21:205–21.
doi: 10.1002/mpr.1352
Blyler CR, Gold JM, Iannone VN, Buchanan RW. Short form of the WAIS-III for use with patients with schizophrenia. Schizophrenia Res. 2000;46:209–15.
doi: 10.1016/S0920-9964(00)00017-7
Velthorst E, Levine SZ, Henquet C, de Haan L, van Os J, Myin-Germeys I, et al. To cut a short test even shorter: reliability and validity of a brief assessment of intellectual ability in schizophrenia—a control-case family study. Cog Neuropsych. 2013;18:574–93.
doi: 10.1080/13546805.2012.731390
Mallet J. MRC sociodemographic schedule. Section of Social Psychiatry, Institute of Psychiatry; 1997.
WHO. Composite international diagnostic interview. Geneva, Switzerland: World Health Organization; 1990.
Di Forti M, Morgan C, Dazzan P, Pariante C, Mondelli V, Marques TR, et al. High-potency cannabis and the risk of psychosis. Br J Psych. 2009;195:488–91.
doi: 10.1192/bjp.bp.109.064220
McGuffin P, Farmer A, Harvey I. A polydiagnostic application of operational criteria in studies of psychotic illness: development and reliability of the OPCRIT system. Arch Gen Psych. 1991;48:764–70.
doi: 10.1001/archpsyc.1991.01810320088015
Craddock N, Asherson P, Owen MJ, Williams J, Mcguffin P, Farmer AE. Concurrent validity of the OPCRIT diagnostic system: comparison of OPCRIT diagnoses with consensus best-estimate lifetime diagnoses. Br J Psych. 1996;169:58–63.
doi: 10.1192/bjp.169.1.58
Singh SP, Cooper JE, Fisher HL, Tarrant CJ, Lloyd T, Banjo J, et al. Determining the chronology and components of psychosis onset: the Nottingham Onset Schedule (NOS). Schizophrenia Res. 2005;80:117–30.
doi: 10.1016/j.schres.2005.04.018
Jones SH, Thornicroft G, Coffey M, Dunn G. A brief mental health outcome scale: reliability and validity of the Global Assessment of Functioning (GAF). Br J Psych. 1995;166:654–9.
doi: 10.1192/bjp.166.5.654
StataCorp. Stata Statistical Software: Release 15. College Station, TX: StataCorp; 2017. https://www.stata.com/features/documentation/ . Accessed on 1 March 2018.
R-Core-Team. A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2014. http://www.R-project.org .
Wickham H. ggplot2: Elegant graphics for data analysis. New York: Springer-Verlag; 2016.
doi: 10.1007/978-3-319-24277-4
Zalesky A, Pantelis C, Cropley V, Fornito A, Cocchi L, McAdams H, et al. Delayed development of brain connectivity in adolescents with schizophrenia and their unaffected siblings. JAMA Psychiatry. 2015;72:900–8.
pubmed: 26176706
doi: 10.1001/jamapsychiatry.2015.0226
Flynn JR. What is intelligence?: Beyond the Flynn effect. Cambridge, UK: Cambridge University Press; 2007.
Salthouse TA. When does age-related cognitive decline begin? Neurobiol Aging. 2009;30:507–14.
pubmed: 19231028
pmcid: 2683339
doi: 10.1016/j.neurobiolaging.2008.09.023
Deary IJ, Corley J, Gow AJ, Harris SE, Houlihan LM, Marioni RE, et al. Age-associated cognitive decline. Br Med Bull. 2009;92:135–52.
pubmed: 19776035
doi: 10.1093/bmb/ldp033
Dutton E, van der Linden D, Lynn R. The negative Flynn Effect: a systematic literature review. Intelligence. 2016;59:163–9.
doi: 10.1016/j.intell.2016.10.002
Teasdale TW, Owen DR. A long-term rise and recent decline in intelligence test performance: the Flynn Effect in reverse. Pers Ind Diff. 2005;39:837–43.
doi: 10.1016/j.paid.2005.01.029
Bratsberg B, Rogeberg O. Flynn effect and its reversal are both environmentally caused. Proc Nat Acad Sci. 2018;115:6674–8.
pubmed: 29891660
pmcid: 6042097
doi: 10.1073/pnas.1718793115
Sachs GA, Carter R, Holtz LR, Smith F, Stump TE, Tu W, et al. Cognitive impairment: an independent predictor of excess mortality: a cohort study. Ann Intern Med. 2011;155:300–8.
pubmed: 21893623
doi: 10.7326/0003-4819-155-5-201109060-00007
Dickinson D. Digit symbol coding and general cognitive ability in schizophrenia: worth another look? Br J Psychiatry. 2008;193:354–6.
pubmed: 18978311
doi: 10.1192/bjp.bp.108.049387
Smeland OB, Frei O, Kauppi K, Hill WD, Li W, Wang Y, et al. Identification of genetic loci jointly influencing schizophrenia risk and the cognitive traits of verbal-numerical reasoning, reaction time, and general cognitive function. JAMA Psychiatry. 2017;74:1065–75.
pubmed: 28746715
pmcid: 5710474
doi: 10.1001/jamapsychiatry.2017.1986
Shafee R, Nanda P, Padmanabhan JL, Tandon N, Alliey-Rodriguez N, Kalapurakkel S, et al. Polygenic risk for schizophrenia and measured domains of cognition in individuals with psychosis and controls. Transl Psychiatry. 2018;8:78.
pubmed: 29643358
pmcid: 5895806
doi: 10.1038/s41398-018-0124-8
Fett AK, Viechtbauer W, Dominguez MD, Penn DL, van Os J, Krabbendam L. The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: a meta-analysis. Neurosci Biobehav Rev. 2011;35:573–88.
pubmed: 20620163
doi: 10.1016/j.neubiorev.2010.07.001
Gold JM. Cognitive deficits as treatment targets in schizophrenia. Schizophr Res. 2004;72:21–28.
pubmed: 15531404
doi: 10.1016/j.schres.2004.09.008
Goldstein JM, Cherkerzian S, Tsuang MT, Petryshen TL. Sex differences in the genetic risk for schizophrenia: History of the evidence for sex‐specific and sex‐dependent effects. Am J Med Gen Part B: Neuropsych Genetics. 2013;162:698–710.
doi: 10.1002/ajmg.b.32159
Loberg EM, Hugdahl K. Cannabis use and cognition in schizophrenia. Front Hum Neurosci. 2009;3:53.
pubmed: 19956405
pmcid: 2786315
doi: 10.3389/neuro.09.053.2009
van Winkel R, Investigators G. Further evidence that cannabis moderates familial correlation of psychosis-related experiences. PLoS One. 2015;10:e0137625.
pubmed: 26384217
pmcid: 4575144
doi: 10.1371/journal.pone.0137625
Van Haren NEM, Van Dam DS, Stellato RK. Genetic risk and outcome of psychosis (group) investigators. Change in IQ in schizophrenia patients and their siblings: a controlled longitudinal study. Psychol Med. 2019;49:2573–81.
pubmed: 30674361
doi: 10.1017/S0033291718003537
Knowles EEM, Mathias SR, Pearlson GD, Barrett J, Mollon J, Denbow D, et al. Clinical correlates of subsyndromal depression in African American individuals with psychosis: The relationship with positive symptoms and comorbid substance dependence. Schizophr Res. 2019;206:333–46.
pubmed: 30482645
doi: 10.1016/j.schres.2018.10.022