Premorbid adjustment problems, negative symptoms, and cognitive impairment in a large international sample at clinical high risk for psychosis: Findings from the Accelerating Medicines Partnership-Schizophrenia.
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Cowan Henry R, Pratt Danielle, Shah Jai L, Woods Scott W, Alameda Luis, Lepage Martin, Shankman Stewart A, Addington Jean, Arango Celso, Bearden Carrie E, Bouix Sylvain, Breitborde Nicholas J K, Broome Matthew R, Cadenhead Kristin S, Calkins Monica E, Castillo-Passi Rolando I, Chen Eric Yu Hai, Choi Jimmy, Conus Philippe, Corcoran Cheryl M, Cornblatt Barbara A, Diaz-Caneja Covadonga M, Ellman Lauren M, Fusar-Poli Paolo, Gaspar Pablo A, Gerber Carla, Glenthøj Louise Birkedal, Gonçalves Cláudia, Horton Leslie E, Hui Christy Lai Ming, Kambeitz Joseph, Kambeitz-Ilankovic Lana, Kahn Rene S, Kane John M, Keshavan Matcheri S, Kim Minah, Kim Sung-Wan, Koutsouleris Nikolaos, Kwon Jun Soo, Langbein Kerstin, Mamah Daniel, Mathalon Daniel H, McGorry Patrick D, Nelson Barnaby, Nordentoft Merete, Pasternak Ofer, Pearlson Godfrey D, Perez Jesus, Perkins Diana O, Powers Albert R, Rogers Jack, Sabb Fred W, Schiffman Jason, Shenton Martha E, Silverstein Steven M, Smesny Stefan, Stone William S, Strauss Gregory P, Thompson Judy L, Upthegrove Rachel, Verma Swapna, Wang Jijun, Wolf Daniel H, Yung Alison, Zhang Tianhong, Crawford Courtney, Yassin Walid, Kelly Sinead, Coleman Michael, Jacobs Grace, Lewandowski Kathryn E, Penzel Nora, Baker Justin, Cecci Guillermo, Allott Kelly, Buccilli Kate, Tod Sophie, Addamo Lauren, Xu Lihua, Accelerating Medicines Partnership®—Schizophrenia (AMP® SCZ), Mittal Vijay A
Аннотация
STUDY DESIGN: Premorbid adjustment and baseline symptoms and cognition were examined in 1056 individuals at CHR (n = 482 early-symptom, n = 574 late-symptom [first CHR-level APS in childhood/early adolescence vs. late adolescence/adulthood]). In the late-symptom group, growth curve models tested adjustment trends from childhood through late adolescence. Incremental relationships between adjustment, symptoms, and cognition were tested controlling for depression/anxiety.
STUDY RESULTS: Premorbid social maladjustment correlated with baseline negative symptoms (r ≥ .25, P < .001). Premorbid academic maladjustment correlated with baseline negative symptoms (r ≥ .17, P ≤ .007) and cognitive impairment (r ≥ .27, P ≤ .001). Effects did not differ between early- and late-symptom subgroups (Δr ≤ .12, z ≤ 2.00, P > .05). Social adjustment deteriorated over time in participants with more baseline negative symptoms (γ = 0.14, P < .001) or cognitive impairment (γ ≥ -0.01, P < .004), even when controlling for depression/anxiety. APS were generally unrelated to premorbid functioning. Effects were consistent in the subsample residing outside North America (n = 579).
CONCLUSIONS: Relationships between premorbid adjustment, negative symptoms, and cognition were independent of depression/anxiety and developmental stage of CHR symptom onset. Baseline negative symptoms and cognitive impairment follow insidious and worsening functional problems originating in early clinical stages, prior to onset of APS.