title: Negative symptoms mediate the relationship between neurocognition and function in individuals at ultrahigh risk for psychosis.
abstract: OBJECTIVE
  Neurocognition is known to impact functioning in individuals at ultrahigh risk (UHR) for psychosis, but studies investigating potential mediators of this relationship are scarce. Building on evidence from schizophrenia spectrum disorders, the study tested whether negative symptoms and social skills act as mediators between neurocognition and functional outcome in UHR individuals.
  
  
  METHODS
  Ultrahigh risk participants (N = 84) underwent neurocognitive testing using the Brief Assessment of Cognition in Schizophrenia. Social skills and negative symptoms were assessed using the High-Risk Social Challenge task and the Scale for the Assessment of Negative Symptoms respectively. Four instruments were used to assess overall functioning, and one instrument assessed quality of life encompassing social functioning.
  
  
  RESULTS
  The cross-sectional analyses revealed that neurocognition was related to the measures of functioning. Negative symptoms mediated the relationship between neurocognition and four of the five measures of functioning. We did not find social skills to mediate between neurocognition and functioning.
  
  
  CONCLUSIONS
  Negative symptoms appear to mediate the relationship between neurocognition and functional outcome in UHR individuals, but the finding needs to be confirmed and extended to longitudinal studies. This underscores the importance of focusing on both neurocognition and negative symptoms when aiming at improving the functional outcome of UHR individuals.
authors.affiliation: Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.|Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.
authors.forename: L B
authors.initials: LB
authors.lastname: Glenthøj
authors.affiliation: Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.|Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark.|Child and Adolescent Mental Health Centre, Mental Health Services Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark.
authors.forename: J R M
authors.initials: JR
authors.lastname: Jepsen
authors.affiliation: Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Hjorthøj
authors.affiliation: Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.|Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark.
authors.forename: N
authors.initials: N
authors.lastname: Bak
authors.affiliation: Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.|Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.
authors.forename: T D
authors.initials: TD
authors.lastname: Kristensen
authors.affiliation: Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.|Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.|Functional Imaging Unit, Department of Diagnostics, Copenhagen University Hospital, Glostrup, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Wenneberg
authors.affiliation: Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.|Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.|Functional Imaging Unit, Department of Diagnostics, Copenhagen University Hospital, Glostrup, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Krakauer
authors.affiliation: Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.|Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Nordentoft
authors.affiliation: Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.|Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark.
authors.forename: B
authors.initials: B
authors.lastname: Fagerlund
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000150:complications* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000503:physiopathology / Q000523:psychology*; D011788:Quality of Life; D012307:Risk Factors; D012919:Social Behavior; D012920:Social Behavior Disorders / Q000150:complications* / Q000523:psychology; D055815:Young Adult
keywords: clinical high-risk psychosis; functioning; mediation; negative symptoms; neurocognition; social skills