title: Neuropsychological profiles in different at-risk states of psychosis: executive control impairment in the early--and additional memory dysfunction in the late--prodromal state.
abstract: Impairments in neuropsychological functioning have been described in subjects clinically at high risk for psychosis, but the specific cognitive deficits in different clinical high-risk groups remain to be elucidated. The German Research Network on Schizophrenia employs a heuristic 2-stage model: a putatively late prodromal state (LPS), characterized by the onset of attenuated positive or brief psychotic symptoms, and an early prodromal state (EPS), mainly characterized by the presence of basic symptoms, which are predictive for psychosis within the next 10 years. A total of 205 subjects met the criteria for either an EPS or an LPS of psychosis and were assessed with a comprehensive neuropsychological test battery. Neurocognitive profiles of high-risk groups were compared with data of 87 healthy controls comparable with regard to gender, age, and premorbid verbal IQ. Patients in the LPS were impaired in all neurocognitive domains (memory/learning, executive control/processing speed, and working memory) examined, with memory being the worst. Deficits were less pronounced in patients in the EPS, with a specific deficit in the executive control/processing speed domain. Consistent with a progressive neurodevelopmental disorder, some cognitive abilities were already impaired in patients in the EPS, followed by further deterioration in the LPS. Specifically, deficits in executive control functioning were related to the presence of basic symptoms, indicating a vulnerability for psychosis. Memory deficits were associated with the onset of psychotic symptoms indicating further disease progression in the trajectory to psychosis and, thus, may be useful in predicting psychosis and targeting early intervention.
authors.affiliation: Department of Psychiatry, University Hospital of Bonn, Sigmund-Freud-Street 25, Bonn, Germany. ingo.frommann@ukb.uni-bonn.de
authors.forename: Ingo
authors.initials: I
authors.lastname: Frommann
authors.forename: Ralf
authors.initials: R
authors.lastname: Pukrop
authors.forename: Jürgen
authors.initials: J
authors.lastname: Brinkmeyer
authors.forename: Andreas
authors.initials: A
authors.lastname: Bechdolf
authors.forename: Stephan
authors.initials: S
authors.lastname: Ruhrmann
authors.forename: Julia
authors.initials: J
authors.lastname: Berning
authors.forename: Petra
authors.initials: P
authors.lastname: Decker
authors.forename: Michael
authors.initials: M
authors.lastname: Riedel
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Möller
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wölwer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gaebel
authors.forename: Joachim
authors.initials: J
authors.lastname: Klosterkötter
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Michael
authors.initials: M
authors.lastname: Wagner
mesh_terms: D000293:Adolescent; D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D018450:Disease Progression; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D015203:Reproducibility of Results; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis* / Q000235:genetics; D012565:Schizophrenic Psychology; D012569:Schizotypal Personality Disorder / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D055815:Young Adult