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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychiatry | doi: 10.3389/fpsyt.2019.00695

Cognitive profile in ultra-high risk for psychosis and schizophrenia: A comparison using coordinated norms.

 Liss Anda1, 2, 3*,  Kolbjørn K. Brønnick4, 5, Jan Olav Johannessen1,  Inge Joa6, 7, Rune A. Kroken3, 8, 9,  Erik Johnsen3, 8, 9, Farivar Fathian10 and Else-Marie Loberg3, 11, 12, 13
  • 1TIPS Network for Clinical Psychosis Research, Stavanger University Hospital, Norway
  • 2Department of Medical and Biological Psychology, Faculty of psychology, University of Bergen, Norway
  • 3Division of Psychiatry, Haukeland University Hospital, Norway
  • 4Centre for Age-Related Medicine, Stavanger University Hospital, Norway
  • 5Deptartment of Public Health, University of Stavanger, Norway
  • 6Stavanger University Hospital , TIPS Network for Clinical Psychosis Research, Stavanger University Hospital, Norway
  • 7Department of Public Health, University of Stavanger, Norway
  • 8Norwegian Center for Mental Disorders Research, Haukeland University Hospital, Norway
  • 9Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Norway
  • 10NKS Olaviken Gerontopsychiatric Hospital, Norway
  • 11Norwegian Centre for Mental Disorders Research, Faculty of Medicine, University of Oslo, Norway
  • 12Department of Addiction Medicine, Haukeland University Hospital, Norway
  • 13Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Norway

Background: Cognitive impairment is a core aspect of schizophrenia but also commonly observed in help seeking youth at ultra-high risk for psychosis (UHR), with potential implications for prognosis and individualised treatment. However, there is no consensus on the cognitive profile in the UHR state, partly due to lack of valid comparisons of performance in established schizophrenia and UHR.

Objectives: To compare the cognitive functioning and profile of UHR subjects to a group with schizophrenia, using coordinated norms based on healthy controls reflecting the younger UHR age spectrum.
Methods: Participants for UHR (n=51) and schizophrenia groups (n=48) were included from the Prevention of Psychosis (POP) and Bergen Psychosis 2 (BP2) projects. All subjects completed a comprehensive neurocognitive test battery aiming to measure processing speed, executive functioning, verbal and spatial ability. Cognitive functioning was compared between groups based on coordinated norms using z-scores derived by regression modelling from an age matched healthy control group (n=61). Results: UHR subjects showed significantly impaired processing speed (p<.001), executive functioning (p=.037) and verbal ability (p=.004) as compared to the control group. Spatial abilities appeared unimpaired. UHR subjects significantly outperformed the schizophrenia group for processing speed (p=.015).

Conclusion: Cognitive performance is impaired in UHR subjects and should be monitored when a person is deemed at high risk of psychotic illness. Spatial skills, as measured by tests using physical objects, appear less affected than other domains. The pattern of impairment is intermediate when compared to groups with schizophrenia and healthy controls.

Keywords: at-mental-risk, psychosis, Schizophrenia, Prodromal, neurocognitive, Cognitive changes, UHR for psychosis, Visuospatial abilities, processing speed, verbal abilities, Executive Function

Received: 28 Mar 2019; Accepted: 28 Aug 2019.

Copyright: © 2019 Anda, Brønnick, Johannessen, Joa, Kroken, Johnsen, Fathian and Loberg. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ms. Liss Anda, Stavanger University Hospital, TIPS Network for Clinical Psychosis Research, Stavanger, 4011, Norway,