title: Can cognitive deficits facilitate differential diagnosis between at-risk mental state for psychosis and depressive disorders?
abstract: OBJECTIVE
  Many studies have provided evidence of cognitive deficits in individuals in an 'At Risk Mental State' (ARMS) for psychosis, which makes neuropsychology potentially useful in the early detection of psychosis. As depression is an important differential diagnosis in prodromal states of psychosis, the specificity of neurocognitive deficits in ARMS individuals as compared with non-psychotic depressive disorders is investigated.
  
  
  METHODS
  Neurocognitive performance of four groups was analysed: 22 ARMS individuals with later transition to psychosis (ARMS-T), 25 ARMS individuals without later transition to psychosis (ARMS-NT), 34 controls with depressive disorders and 76 healthy controls. The subjects were assessed with a neurocognitive test battery covering the domains' intelligence, executive function and attention/ working memory. MANOVAs, ANOVAs and Tukey's tests were applied after adjustment for confounding factors.
  
  
  RESULTS
  ARMS-T showed significant cognitive deficits in working memory and in certain executive function tasks compared with healthy controls as well as with controls with depression. Controls with depression were only impaired in time per move in the tower of Hanoi test when compared with healthy controls.
  
  
  CONCLUSIONS
  The psychosis prodrome seems to be associated with cognitive deficits in the domains of working memory and executive function. In contrast, depressive patients showed no cognitive deficits, but slowing in one executive function task. Neurocognitive testing might therefore contribute to the differential diagnosis between prodromal psychosis and depressive disorders.
authors.affiliation: University Psychiatric Outpatient Department, University of Basel Psychiatric Clinics, Basel, Switzerland.
authors.forename: Carla
authors.initials: C
authors.lastname: Schulze
authors.forename: Ronan
authors.initials: R
authors.lastname: Zimmermann
authors.forename: Ute
authors.initials: U
authors.lastname: Gschwandtner
authors.forename: Marlon O
authors.initials: MO
authors.lastname: Pflueger
authors.forename: Charlotte
authors.initials: C
authors.lastname: Rapp
authors.forename: Erich
authors.initials: E
authors.lastname: Studerus
authors.forename: Anita
authors.initials: A
authors.lastname: Riecher-Rössler
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000150:complications* / Q000523:psychology*; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D062706:Prodromal Symptoms; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology