title: Neuropsychological clustering highlights cognitive differences in young people presenting with depressive symptoms.
abstract: Early stages of affective or psychotic disorders may be accompanied by neuropsychological changes that help to predict risk of developing more severe disorders. A comprehensive set of neuropsychological measures was collected in 109 help-seeking young people (16 to 30 years; 54 females), recently diagnosed with an affective or psychotic disorder and presenting with current depression. Hierarchical cluster analysis determined three clusters: one deemed to have a "poor memory" profile (n = 40); another with a "poor mental flexibility" profile (n = 38) and a third with widespread difficulties plus "impaired attention and memory" (n = 31). In general, the three clusters were comparable in demographic, functional and clinical factors suggesting some unique role for neurocognitive impairments. A discriminant function analysis confirmed that the clusters were best characterized by performance in "attentional" versus "learning/memory" measures. Furthermore, profiles of independent neuropsychological variables validated the original solution for two of the clusters, distinguishing all cluster-groups on an attentional measure. The findings of this study suggest that despite presenting with very similar levels of current depressive symptomatology, young help-seeking individuals in the early stages of illness have underlying neuropsychological heterogeneity. Distinct neuropsychological profiling may help to predict later psychiatric outcomes and enhance individually-tailored early intervention strategies.
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Sydney, Australia. daniel.hermens@sydney.edu.au
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Hermens
authors.forename: M Antoinette
authors.initials: MA
authors.lastname: Redoblado Hodge
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Naismith
authors.forename: Manreena
authors.initials: M
authors.lastname: Kaur
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Scott
authors.forename: Ian B
authors.initials: IB
authors.lastname: Hickie
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D016000:Cluster Analysis; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D055815:Young Adult