title: Longitudinal change in neurocognition and its relation to symptomatic and functional changes over 2years in individuals at clinical high-risk for psychosis.
abstract: Negative symptoms and functional disability represent the core of schizophrenia and both are associated with cognitive impairments. We explored the course of cognitive change and its relation to symptomatic and functional changes in individuals at clinical high-risk (CHR) for psychosis to identify cognitive indicators of long-term course. Such attempts may offer insight into the pathological changes associated with the development of illness in the prodromal state.
  
  
  
  Forty-seven CHR individuals completed neurocognitive, clinical, and functional assessments at baseline and 2-year follow-up; twenty-eight healthy controls were assessed for neurocognitive and functional measures at baseline and 2-year follow-up. The delta values of CHR individuals in neurocognitive, clinical, and functional domains were determined from differences between baseline and follow-up scores to estimate the degree of change.
  
  
  
  Although overall longitudinal cognitive performance of CHR individuals improved, the magnitude of improvement was not statistically different from that of normal controls at the group level. However, the individual data yielded two groups of CHR subjects showing opposite trajectories of cognitive change in semantic fluency (i.e., improvement or decline), which was significantly associated with changes in negative symptoms and functioning. Moreover, the relationships between negative symptoms and functioning were more strengthened over time than baseline.
  
  
  
  Our findings show that semantic fluency seems to be a neurocognitive indicator reflecting clinical courses in CHR individuals. The longitudinal relationship of negative symptoms and functioning with semantic fluency may represent ongoing pathological processes in neural systems involving aberrant fronto-temporal interaction in the early phase of schizophrenia.
authors.affiliation: Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.
authors.forename: Ye Seul
authors.initials: YS
authors.lastname: Shin
authors.affiliation: Department of Psychology, Duksung Women's University, Seoul, Republic of Korea.
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea.
authors.forename: Tae Young
authors.initials: TY
authors.lastname: Lee
authors.affiliation: Department of Psychology, Chung-Ang University, Seoul, Republic of Korea.
authors.forename: Ji-Won
authors.initials: JW
authors.lastname: Hur
authors.affiliation: Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea.
authors.forename: Na Young
authors.initials: NY
authors.lastname: Shin
authors.affiliation: Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung Nyun
authors.initials: SN
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Min-Sup
authors.initials: MS
authors.lastname: Shin
authors.affiliation: Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: kwonjs@snu.ac.kr.
authors.forename: Jun Soo
authors.initials: JS
authors.lastname: Kwon
mesh_terms: D000328:Adult; D003071:Cognition; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D062706:Prodromal Symptoms; D011618:Psychotic Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D012306:Risk; D012919:Social Behavior; D011795:Surveys and Questionnaires; D013997:Time Factors; D014888:Wechsler Scales; D055815:Young Adult
keywords: Clinical high-risk; Functional outcome; Longitudinal; Negative symptom; Neurocognition; Schizophrenia