title: Neurocognition in help-seeking individuals at risk for psychosis: Prediction of outcome after 24 months.
abstract: An important aim in schizophrenia research is to optimize the prediction of psychosis and to improve strategies for early intervention. The objectives of this study were to explore neurocognitive performance in individuals at risk for psychosis and to optimize predictions through a combination of neurocognitive and psychopathological variables. Information on clinical outcomes after 24 months was available from 118 subjects who had completed an extensive assessment at baseline. Subjects who had converted to psychosis were compared with subjects who had not. Multivariate Cox regression analyses were used to determine which baseline measure best predicted a conversion to psychosis. The premorbid IQ and the neurocognitive domains of processing speed, learning/memory, working memory and verbal fluency significantly discriminated between converters and non-converters. When entered into multivariate regression analyses, the combination of PANSS positive/negative symptom severity and IQ best predicted the clinical outcomes. Our results confirm previous evidence suggesting moderate premorbid cognitive deficits in individuals developing full-blown psychosis. Overall, clinical symptoms appeared to be a more sensitive predictor than cognitive performance. Nevertheless, the two might serve as complementary predictors when assessing the risk for psychosis.
authors.affiliation: The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Switzerland. Electronic address: sibylle.metzler@dgsp.uzh.ch.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Metzler
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland.
authors.forename: Diane
authors.initials: D
authors.lastname: Dvorsky
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland.
authors.forename: Christine
authors.initials: C
authors.lastname: Wyss
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland.
authors.forename: Carlos
authors.initials: C
authors.lastname: Nordt
authors.affiliation: Department of Child and Adolescent Psychiatry, University of Zurich, Switzerland.
authors.forename: Susanne
authors.initials: S
authors.lastname: Walitza
authors.affiliation: The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Switzerland; Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland.
authors.forename: Karsten
authors.initials: K
authors.lastname: Heekeren
authors.affiliation: The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Switzerland; Collegium Helveticum, a joint Research Institute between the University of Zurich and the Swiss Federal Institute of Technology Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Wulf
authors.initials: W
authors.lastname: Rössler
authors.affiliation: The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich, Switzerland; Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Theodoridou
mesh_terms: D000293:Adolescent; D000328:Adult; D060825:Cognitive Dysfunction / Q000503:physiopathology / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D000066505:Help-Seeking Behavior; D006801:Humans; D007858:Learning / Q000502:physiology; D008297:Male; D008568:Memory / Q000502:physiology; D008570:Memory, Short-Term / Q000502:physiology; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D062706:Prodromal Symptoms; D016016:Proportional Hazards Models; D011618:Psychotic Disorders / Q000503:physiopathology / Q000523:psychology*; D012306:Risk; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D055815:Young Adult
keywords: Cognition; Neuropsychology; Prediction; Prodrome; Psychosis