Clinical and neurocognitive profiles of subjects at high risk for psychosis with and without obsessive-compulsive symptoms.
OBJECTIVE
Obsessive-compulsive symptoms (OCS), which are common in psychotic-spectrum illnesses, are of clinical interest because of their association with poor prognosis or cognitive dysfunction. However, few studies on the clinical and neurocognitive implications of OCS in individuals at ultra-high risk for psychosis (UHR) have been conducted.


METHODS
Sixty-five UHR subjects [24 with OCS (UHR+OCS), 41 without OCS (UHR-OCS)], and 40 healthy controls were assessed using clinical scales and neurocognitive tests.


RESULTS
Those with UHR+OCS showed more severe clinical symptoms and poorer global functioning as compared to both healthy controls and the UHR-OCS group, according to the results of the Global Assessment of Functioning, the Comprehensive Assessment of At-Risk Mental States, and the Positive and Negative Syndrome Scale (total, negative, and general scores). In the neurocognitive domain, those in the UHR-OCS group showed notably greater latency in the Stroop task and more confabulation errors in immediate recall in the Rey-Osterrieth Complex Figure Test compared with those in UHR+OCS group, whose performance levels were similar to those of the healthy control group.


CONCLUSIONS
The OCS manifested in UHR individuals was associated with a more severe clinical symptomatic presentation, including lower global functioning and more psychotic symptoms. On the other hand, those with UHR-OCS performed more poorly on some cognitive tests. The features that distinguish the groups can be used for developing prognoses and intervention strategies for the heterogeneous UHR group.
Department of Brain and Cognitive Sciences-World Class University Program, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.
Ji-Won
JW
Hur
Na Young
NY
Shin
Joon Hwan
JH
Jang
Geumsook
G
Shim
Hye Yoon
HY
Park
Jae Yeon
JY
Hwang
Sung Nyun
SN
Kim
Jung Hyun
JH
Yoo
Kyung Sue
KS
Hong
Jun Soo
JS
Kwon
D000293:Adolescent; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000150:complications / Q000503:physiopathology*; D003192:Compulsive Behavior / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000150:complications / Q000503:physiopathology*; D011939:Mental Recall; D009483:Neuropsychological Tests; D009770:Obsessive Behavior / Q000503:physiopathology*; D011379:Prognosis; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D057190:Stroop Test; D055815:Young Adult