title: Subjects at Ultra High Risk for psychosis have 'heterogeneous' intellectual functioning profile: a multiple-case study.
abstract: In Ultra High Risk (UHR) studies, intellectual functioning is commonly assessed using premorbid IQ tools as a covariate. The aim of this study was to show that the use of the Wechsler Adult Intelligence Scale (WAIS) could yield accurate neuropsychological profiling and that an alternative approach such as a multiple-case study could be a more interesting way to isolate discrete cognitive processes in the early stage of illness. The studied population consisted of 198 adolescents and young adults (16-30 y.o.) referred to our outpatient clinic. After the CAARMS' interview, we defined 3 subgroups: UHR (N=104), First Episode (FE; N=30), and Help-Seekers (HS; N=64) who were neither UHR nor psychotic. Intellectual functioning was assessed by the WAIS-III (9 subtests version) and 'heterogeneous' intellectual profiles were defined based on the existence of a 3-point difference in scoring at subtests constitutive of the same WAIS index. While UHR did not differ from FE or HS on WAIS' scores and sub-scores, the multiple-case study indicated a higher proportion of 'heterogeneous' profiles in the Verbal Comprehension Index in the UHR sample than in FE and HS (p=0.04). The disease progression could heterogeneously impact on specific domains, in patterns depending on the stage of the illness. This approach exploring intra-subject WAIS performances might be more relevant than the use of global scores in detecting the subtle cognitive alteration of emerging psychosis.
authors.affiliation: Université Paris Descartes, PRES Paris Sorbonne Cité, INSERM, Laboratoire de Physiopathologie des Maladies Psychiatriques, Centre de Psychiatrie et Neurosciences, UMR 894, Paris, France; Hôpital Sainte-Anne, Centre d'évaluation des Jeunes Adultes et Adolescents (C'JAAD), Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France. Electronic address: emagaud@ucalgary.ca.
authors.forename: Emilie
authors.initials: E
authors.lastname: Magaud
authors.affiliation: Université Paris Descartes, PRES Paris Sorbonne Cité, INSERM, Laboratoire de Physiopathologie des Maladies Psychiatriques, Centre de Psychiatrie et Neurosciences, UMR 894, Paris, France; Laboratoire Cognition, Santé, Socialisation, C2S, EA6291, Université de Reims Champagne-Ardenne, France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Morvan
authors.affiliation: Université Paris Descartes, PRES Paris Sorbonne Cité, INSERM, Laboratoire de Physiopathologie des Maladies Psychiatriques, Centre de Psychiatrie et Neurosciences, UMR 894, Paris, France; Hôpital Sainte-Anne, Centre d'évaluation des Jeunes Adultes et Adolescents (C'JAAD), Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Rampazzo
authors.affiliation: Université Paris Descartes, PRES Paris Sorbonne Cité, INSERM, Laboratoire de Physiopathologie des Maladies Psychiatriques, Centre de Psychiatrie et Neurosciences, UMR 894, Paris, France; Hôpital Sainte-Anne, Centre d'évaluation des Jeunes Adultes et Adolescents (C'JAAD), Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Alexandre
authors.affiliation: Université Paris Descartes, PRES Paris Sorbonne Cité, INSERM, Laboratoire de Physiopathologie des Maladies Psychiatriques, Centre de Psychiatrie et Neurosciences, UMR 894, Paris, France; Hôpital Sainte-Anne, Centre d'évaluation des Jeunes Adultes et Adolescents (C'JAAD), Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Willard
authors.affiliation: Université Paris Descartes, PRES Paris Sorbonne Cité, INSERM, Laboratoire de Physiopathologie des Maladies Psychiatriques, Centre de Psychiatrie et Neurosciences, UMR 894, Paris, France; Hôpital Sainte-Anne, Centre d'évaluation des Jeunes Adultes et Adolescents (C'JAAD), Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Gaillard
authors.affiliation: Hôpital Sainte-Anne, Centre d'évaluation des Jeunes Adultes et Adolescents (C'JAAD), Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Kazes
authors.affiliation: Université Paris Descartes, PRES Paris Sorbonne Cité, INSERM, Laboratoire de Physiopathologie des Maladies Psychiatriques, Centre de Psychiatrie et Neurosciences, UMR 894, Paris, France; Hôpital Sainte-Anne, Centre d'évaluation des Jeunes Adultes et Adolescents (C'JAAD), Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.
authors.forename: Marie-Odile
authors.initials: MO
authors.lastname: Krebs
mesh_terms: D000293:Adolescent; D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007360:Intelligence; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D014888:Wechsler Scales; D055815:Young Adult
keywords: Adolescents; Early detection; High functioning; Intelligence; Neuropsychological; Schizophrenia