Investigation of Neurocognitive Deficits, Quality of Life, and Functional Performance in Ultra-High-Risk Individuals Compared to Familial High-Risk Individuals for Schizophrenia
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Abstract
Objective: This study aimed to investigate neurocognitive functioning, quality of life, and global functional performance in Ultra-High Risk (UHR) individuals compared to Familial High-Risk (FHR) individuals for developing schizophrenia.
Method: An observational cross-sectional study was conducted using a convenient sampling method at Roozbeh Hospital in Tehran, Iran, from June 2017 to January 2020. The study included 40 UHR individuals based on the Structured Interview for Psychosis Syndrome (SIPS) interview, as well as 34 FHR individuals due to genetic risk. Neurocognitive functioning, quality of life, and global functional performance were assessed by using the Cambridge Automated Neuropsychological Test Battery (CANTAB) and Controlled Oral Word Association Test (COWAT), Quality of Life Scale (QLS), and Global Assessment of Functioning (GAF).
Results: UHR individuals for schizophrenia demonstrated significant lower scores in phonemic and semantic verbal fluency (t = 6.218, P < 0.001; t = 4.184, P < 0.001, respectively), more total errors for spatial working memory (t = -5.874, P < 0.001), and fewer problems solved in minimum moves in Stocking of Cambridge (SOC) (t = -2.706, P < 0.01) compared to FHR individuals. Intra-Extra Dimension (IED) did not differ significantly between the two groups. Moreover, the study indicated significant GAF decline (F = 79.257, P < 0.001) and lower total score on the QLS (t = -10.655, P < 0.001) in UHR compared to FHR individuals.
Conclusion: It is possible to differentiate UHR individuals from FHR individuals through neurocognitive, quality of life, and global functioning assessment.
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23. Becker HE, Nieman DH, Dingemans PM, van de Fliert JR, De Haan L, Linszen DH. Verbal fluency as a possible predictor for psychosis. Eur Psychiatry. 2010;25(2):105-10.
24. Yung AR, Nelson B, McGorry PD, Wood SJ, Lin A. Persistent negative symptoms in individuals at Ultra High Risk for psychosis. Schizophr Res. 2019;206:355-61.
25. Magaud E, Kebir O, Gut A, Willard D, Chauchot F, Olie JP, et al. Altered semantic but not phonological verbal fluency in young help-seeking individuals with ultra high risk of psychosis. Schizophr Res. 2010;123(1):53-8.
26. Forbes NF, Carrick LA, McIntosh AM, Lawrie SM. Working memory in schizophrenia: a meta-analysis. Psychol Med. 2009;39(6):889-905.
27. Barbey AK, Koenigs M, Grafman J. Dorsolateral prefrontal contributions to human working memory. Cortex. 2013;49(5):1195-205.
28. Smucny J, Dienel SJ, Lewis DA, Carter CS. Mechanisms underlying dorsolateral prefrontal cortex contributions to cognitive dysfunction in schizophrenia. Neuropsychopharmacology. 2022;47(1):292-308.
29. Wood SJ, Pantelis C, Proffitt T, Phillips LJ, Stuart GW, Buchanan JA, et al. Spatial working memory ability is a marker of risk-for-psychosis. Psychol Med. 2003;33(7):1239-47.
30. Bora E, Lin A, Wood SJ, Yung AR, McGorry PD, Pantelis C. Cognitive deficits in youth with familial and clinical high risk to psychosis: a systematic review and meta-analysis. Acta Psychiatr Scand. 2014;130(1):1-15.
31. Anda L, Brønnick KK, Johannessen JO, Joa I, Kroken RA, Johnsen E, et al. Cognitive Profile in Ultra High Risk for Psychosis and Schizophrenia: A Comparison Using Coordinated Norms. Front Psychiatry. 2019;10:695.
32. Burgess PW. Theory and methodology in executive function research. Methodology of frontal and executive function: Routledge; 2004. p. 87-121.
33. Hwang WJ, Lee TY, Shin WG, Kim M, Kim J, Lee J, Kwon JS. Global and Specific Profiles of Executive Functioning in Prodromal and Early Psychosis. Front Psychiatry. 2019;10:356.
34. Kim KR, Song YY, Park JY, Lee EH, Lee M, Lee SY, et al. The relationship between psychosocial functioning and resilience and negative symptoms in individuals at ultra-high risk for psychosis. Aust N Z J Psychiatry. 2013;47(8):762-71.
35. Woon PS, Chia MY, Chan WY, Sim K. Neurocognitive, clinical and functional correlates of subjective quality of life in Asian outpatients with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry. 2010;34(3):463-8.
36. Eack SM, Newhill CE. Psychiatric symptoms and quality of life in schizophrenia: a meta-analysis. Schizophr Bull. 2007;33(5):1225-37.
2. Yung AR, Phillips LJ, Yuen HP, Francey SM, McFarlane CA, Hallgren M, McGorry PD. Psychosis prediction: 12-month follow up of a high-risk ("prodromal") group. Schizophr Res. 2003;60(1):21-32.
3. Yung AR. Treatment of people at ultra-high risk for psychosis. World Psychiatry. 2017;16(2):207-8.
4. Yung AR, McGorry PD. The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophr Bull. 1996;22(2):353-70.
5. Miller TJ, McGlashan TH, Rosen JL, Cadenhead K, Cannon T, Ventura J, et al. Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability. Schizophr Bull. 2003;29(4):703-15.
6. Cardno AG, Marshall EJ, Coid B, Macdonald AM, Ribchester TR, Davies NJ, et al. Heritability estimates for psychotic disorders: the Maudsley twin psychosis series. Arch Gen Psychiatry. 1999;56(2):162-8.
7. Green MF, Kern RS, Braff DL, Mintz J. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the "right stuff"? Schizophr Bull. 2000;26(1):119-36.
8. Valle R. Schizophrenia in ICD-11: Comparison of ICD-10 and DSM-5. Rev Psiquiatr Salud Ment (Engl Ed). 2020;13(2):95-104.
9. Reichenberg A. The assessment of neuropsychological functioning in schizophrenia. Dialogues Clin Neurosci. 2010;12(3):383-92.
10. Mesholam-Gately RI, Giuliano AJ, Goff KP, Faraone SV, Seidman LJ. Neurocognition in first-episode schizophrenia: a meta-analytic review. Neuropsychology. 2009;23(3):315-36.
11. Pukrop R, Schultze-Lutter F, Ruhrmann S, Brockhaus-Dumke A, Tendolkar I, Bechdolf A, et al. Neurocognitive functioning in subjects at risk for a first episode of psychosis compared with first- and multiple-episode schizophrenia. J Clin Exp Neuropsychol. 2006;28(8):1388-407.
12. Seidman LJ, Shapiro DI, Stone WS, Woodberry KA, Ronzio A, Cornblatt BA, et al. Association of Neurocognition With Transition to Psychosis: Baseline Functioning in the Second Phase of the North American Prodrome Longitudinal Study. JAMA Psychiatry. 2016;73(12):1239-48.
13. Karow A, Wittmann L, Schöttle D, Schäfer I, Lambert M. The assessment of quality of life in clinical practice in patients with schizophrenia. Dialogues Clin Neurosci. 2014;16(2):185-95.
14. Üçok A, Direk N, Koyuncu A, Keskin-Ergen Y, Yüksel Ç, Güler J, et al. Cognitive deficits in clinical and familial high risk groups for psychosis are common as in first episode schizophrenia. Schizophr Res. 2013;151(1-3):265-9.
15. Hormozpour M, Amini H, Pajouhanfar S, Faghankhani M, Rahmani A, Sharifi V. Transition to Psychosis: Evaluation of the First-Degree Relatives of Patients with Schizophrenia . Iran J Psychiatry. 2016;11(1):15-23.
16. McGlashan TH, Miller TJ, Woods SW, Hoffman RE, Davidson L. Instrument for the assessment of prodromal symptoms and states. Early intervention in psychotic disorders. 2001:135-49.
17. Sahakian BJ, Owen AM. Computerized assessment in neuropsychiatry using CANTAB: discussion paper. J R Soc Med. 1992;85(7):399-402.
18. Ross TP, Calhoun E, Cox T, Wenner C, Kono W, Pleasant M. The reliability and validity of qualitative scores for the Controlled Oral Word Association Test. Arch Clin Neuropsychol. 2007;22(4):475-88.
19. Ghasemian-Shirvan E, Molavi Shirazi S, Aminikhoo M, Zareaan M, Ekhtiari H. Preliminary Normative Data of Persian Phonemic and Semantic Verbal Fluency Test. Iran J Psychiatry. 2018;13(4):288-95.
20. Hall RC. Global assessment of functioning. A modified scale. Psychosomatics. 1995;36(3):267-75.
21. Heinrichs DW, Hanlon TE, Carpenter WT, Jr. The Quality of Life Scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull. 1984;10(3):388-98.
22. Masoomi M, Shadloo B, Nedjat S, Bahrami Z, Sharifi V, Amini H. Validity and reliability of the Persian version of the “Quality of Life Scale” in schizophrenia. IJPBS. 2018;12(3).
23. Becker HE, Nieman DH, Dingemans PM, van de Fliert JR, De Haan L, Linszen DH. Verbal fluency as a possible predictor for psychosis. Eur Psychiatry. 2010;25(2):105-10.
24. Yung AR, Nelson B, McGorry PD, Wood SJ, Lin A. Persistent negative symptoms in individuals at Ultra High Risk for psychosis. Schizophr Res. 2019;206:355-61.
25. Magaud E, Kebir O, Gut A, Willard D, Chauchot F, Olie JP, et al. Altered semantic but not phonological verbal fluency in young help-seeking individuals with ultra high risk of psychosis. Schizophr Res. 2010;123(1):53-8.
26. Forbes NF, Carrick LA, McIntosh AM, Lawrie SM. Working memory in schizophrenia: a meta-analysis. Psychol Med. 2009;39(6):889-905.
27. Barbey AK, Koenigs M, Grafman J. Dorsolateral prefrontal contributions to human working memory. Cortex. 2013;49(5):1195-205.
28. Smucny J, Dienel SJ, Lewis DA, Carter CS. Mechanisms underlying dorsolateral prefrontal cortex contributions to cognitive dysfunction in schizophrenia. Neuropsychopharmacology. 2022;47(1):292-308.
29. Wood SJ, Pantelis C, Proffitt T, Phillips LJ, Stuart GW, Buchanan JA, et al. Spatial working memory ability is a marker of risk-for-psychosis. Psychol Med. 2003;33(7):1239-47.
30. Bora E, Lin A, Wood SJ, Yung AR, McGorry PD, Pantelis C. Cognitive deficits in youth with familial and clinical high risk to psychosis: a systematic review and meta-analysis. Acta Psychiatr Scand. 2014;130(1):1-15.
31. Anda L, Brønnick KK, Johannessen JO, Joa I, Kroken RA, Johnsen E, et al. Cognitive Profile in Ultra High Risk for Psychosis and Schizophrenia: A Comparison Using Coordinated Norms. Front Psychiatry. 2019;10:695.
32. Burgess PW. Theory and methodology in executive function research. Methodology of frontal and executive function: Routledge; 2004. p. 87-121.
33. Hwang WJ, Lee TY, Shin WG, Kim M, Kim J, Lee J, Kwon JS. Global and Specific Profiles of Executive Functioning in Prodromal and Early Psychosis. Front Psychiatry. 2019;10:356.
34. Kim KR, Song YY, Park JY, Lee EH, Lee M, Lee SY, et al. The relationship between psychosocial functioning and resilience and negative symptoms in individuals at ultra-high risk for psychosis. Aust N Z J Psychiatry. 2013;47(8):762-71.
35. Woon PS, Chia MY, Chan WY, Sim K. Neurocognitive, clinical and functional correlates of subjective quality of life in Asian outpatients with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry. 2010;34(3):463-8.
36. Eack SM, Newhill CE. Psychiatric symptoms and quality of life in schizophrenia: a meta-analysis. Schizophr Bull. 2007;33(5):1225-37.
| Files | ||
| Issue | Vol 18 No 4 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v18i4.13629 | |
| Keywords | ||
| Cognition Neuropsychology Prodromal Signs Psychosis Schizophrenia | ||
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How to Cite
1.
Fallah Zadeh MA, Amini H, Sharifi V, Tehranidoost M, Noroozian M. Investigation of Neurocognitive Deficits, Quality of Life, and Functional Performance in Ultra-High-Risk Individuals Compared to Familial High-Risk Individuals for Schizophrenia. Iran J Psychiatry. 2023;18(4):420-428.
