title: Neuropsychological profile according to the clinical stage of young persons presenting for mental health care.
abstract: BACKGROUND
  Clinical staging of mental disorders proposes that individuals can be assessed at various sub-syndromal and later developed phases of illness. As an adjunctive rating, it may complement traditional diagnostic silo-based approaches. In this study, we sought to determine the relationships between clinical stage and neuropsychological profile in young persons presenting to youth-focused mental health services.
  
  
  METHODS
  Neuropsychological testing of 194 help-seeking young people (mean age 22.6 years, 52% female) and 50 healthy controls. Clinical staging rated 94 persons as having an 'attenuated syndrome' (stage 1b) and 100 with a discrete or persistent disorder (stage 2/3).
  
  
  RESULTS
  The discrete disorder group (stage 2/3) showed the most impaired neuropsychological profile, with the earlier stage (1b) group showing an intermediate profile, compared to controls. Greatest impairments were seen in verbal memory and executive functioning. To address potential confounds created by 'diagnosis', profiles for those with a mood syndrome or disorder but not psychosis were also examined and the neuropsychological impairments for the stage 2/3 group remained.
  
  
  CONCLUSIONS
  The degree of neuropsychological impairment in young persons with mental disorders appears to discriminate those with attenuated syndromes from those with a discrete disorder, independent of diagnostic status and current symptoms. Our findings suggest that neuropsychological assessment is a critical aspect of clinical evaluation of young patients at the early stages of a major psychiatric illness.
authors.affiliation: Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Hermens
authors.affiliation: Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Naismith
authors.affiliation: Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia.
authors.forename: Jim
authors.initials: J
authors.lastname: Lagopoulos
authors.affiliation: Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia.
authors.forename: Rico S C
authors.initials: RS
authors.lastname: Lee
authors.affiliation: Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Guastella
authors.affiliation: Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Scott
authors.affiliation: Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia.
authors.forename: Ian B
authors.initials: IB
authors.lastname: Hickie
keywords: Clinical staging; Neuropsychology; Psychiatric; Young adults