TY - JOUR
T1 - Twelve-Month Cognitive Trajectories in Individuals at Ultra-High Risk for Psychosis
T2 - A Latent Class Analysis
AU - Allott, Kelly
AU - Schmidt, Stefanie J.
AU - Yuen, Hok Pan
AU - Wood, Stephen J.
AU - Nelson, Barnaby
AU - Markulev, Connie
AU - Lavoie, Suzie
AU - Brewer, Warrick J.
AU - Schäfer, Miriam R.
AU - Mossaheb, Nilufar
AU - Schlögelhofer, Monika
AU - Smesny, Stefan
AU - Hickie, Ian B.
AU - Berger, Gregor Emanuel
AU - Chen, Eric Y. H.
AU - de Haan, Lieuwe
AU - Nieman, Dorien H.
AU - Nordentoft, Merete
AU - Riecher-Rössler, Anita
AU - Verma, Swapna
AU - Thompson, Andrew
AU - Yung, Alison R.
AU - Amminger, Paul
AU - McGorry, Patrick D.
AU - Hartmann, Jessica
N1 - Funding Information: This work was supported by grant 07TGF-1102 from the Stanley Medical Research Institute, grant 566529 from the National Health and Medical Research Council (NHMRC) Australia (Drs McGorry, Hickie, and Yung, and Amminger), and a grant from the Colonial Foundation. Dr Allott was supported by a Career Development Fellowship from the NHMRC Australia (1141207) and a Dame Kate Campbell Fellowship from The University of Melbourne; Drs Amminger and Yung were supported by NHMRC Senior Research Fellowships 1080963 and 566593, respectively; Dr Nelson was supported by NHMRC Career Development Fellowship 1027532; and Dr McGorry was supported by Senior Principal Research Fellowship 1060996 from the NHMRC. Publisher Copyright: © 2022 The Author(s) 2022. Published by Oxford University Press on behalf of the University of Maryland's school of medicine, Maryland Psychiatric Research Center.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Understanding longitudinal cognitive performance in individuals at ultra-high risk for psychosis (UHR) is important for informing theoretical models and treatment. A vital step in this endeavor is to determine whether there are UHR subgroups that have similar patterns of cognitive change over time. The aims were to: i) identify latent class trajectories of cognitive performance over 12-months in UHR individuals, ii) identify baseline demographic and clinical predictors of the resulting classes, and iii) determine whether trajectory classes were associated with transition to psychosis or functional outcomes. Cognition was assessed using the Brief Assessment of Cognition in Schizophrenia (BACS) at baseline, 6- and 12-months (N = 288). Using Growth Mixture Modeling, a single unimpaired improving trajectory class was observed for motor function, speed of processing, verbal fluency, and BACS composite. A two-class solution was observed for executive function and working memory, showing one unimpaired and a second impaired class. A three-class solution was found for verbal learning and memory: unimpaired, mildly impaired, and initially extremely impaired, but improved ("caught up") to the level of the mildly impaired. IQ, omega-3 index, and premorbid adjustment were associated with class membership, whereas clinical variables (symptoms, substance use), including transition to psychosis, were not. Working memory and verbal learning and memory trajectory class membership was associated with functioning outcomes. These findings suggest there is no short-term progressive cognitive decline in help-seeking UHR individuals, including those who transition to psychosis. Screening of cognitive performance may be useful for identifying UHR individuals who may benefit from targeted cognitive interventions.
AB - Understanding longitudinal cognitive performance in individuals at ultra-high risk for psychosis (UHR) is important for informing theoretical models and treatment. A vital step in this endeavor is to determine whether there are UHR subgroups that have similar patterns of cognitive change over time. The aims were to: i) identify latent class trajectories of cognitive performance over 12-months in UHR individuals, ii) identify baseline demographic and clinical predictors of the resulting classes, and iii) determine whether trajectory classes were associated with transition to psychosis or functional outcomes. Cognition was assessed using the Brief Assessment of Cognition in Schizophrenia (BACS) at baseline, 6- and 12-months (N = 288). Using Growth Mixture Modeling, a single unimpaired improving trajectory class was observed for motor function, speed of processing, verbal fluency, and BACS composite. A two-class solution was observed for executive function and working memory, showing one unimpaired and a second impaired class. A three-class solution was found for verbal learning and memory: unimpaired, mildly impaired, and initially extremely impaired, but improved ("caught up") to the level of the mildly impaired. IQ, omega-3 index, and premorbid adjustment were associated with class membership, whereas clinical variables (symptoms, substance use), including transition to psychosis, were not. Working memory and verbal learning and memory trajectory class membership was associated with functioning outcomes. These findings suggest there is no short-term progressive cognitive decline in help-seeking UHR individuals, including those who transition to psychosis. Screening of cognitive performance may be useful for identifying UHR individuals who may benefit from targeted cognitive interventions.
KW - cognition
KW - growth mixture modeling
KW - longitudinal
KW - omega-3 index
KW - schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=85131625058&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/schizbullopen/sgac008
DO - https://doi.org/10.1093/schizbullopen/sgac008
M3 - Article
SN - 2632-7899
VL - 3
JO - Schizophrenia Bulletin Open
JF - Schizophrenia Bulletin Open
IS - 1
M1 - sgac008
ER -