TY - JOUR
T1 - Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings
AU - Velthorst, E.
AU - Mollon, J.
AU - Murray, R.M.
AU - de Haan, L.
AU - Germeys, I.M.
AU - Glahn, D.C.
AU - Arango, C.
AU - van der Ven, E.
AU - Di Forti, M.
AU - Bernardo, M.
AU - Guloksuz, S.
AU - Delespaul, P.
AU - Mezquida, G.
AU - Amoretti, S.
AU - Bobes, J.
AU - Saiz, P.A.
AU - Garcia-Portilla, M.P.
AU - Santos, J.L.
AU - Jimenez-Lopez, E.
AU - Sanjuan, J.
AU - Aguilar, E.J.
AU - Arrojo, M.
AU - Carracedo, A.
AU - Lopez, G.
AU - Gonzalez-Penas, J.
AU - Parellada, M.
AU - Atbasoglu, C.
AU - Saka, M.C.
AU - Ucok, A.
AU - Alptekin, K.
AU - Akdede, B.
AU - Binbay, T.
AU - Altinyazar, V.
AU - Ulas, H.
AU - Yalincetin, B.
AU - Gumus-AkaY, G.
AU - Beyaz, B.C.
AU - Soygur, H.
AU - Cankurtaran, E.S.
AU - Kaymak, S.U.
AU - Maric, N.P.
AU - Mihaljevic, M.M.
AU - Petrovic, S.A.
AU - Mirjanic, T.
AU - Del-Ben, C.M.
AU - Ferraro, L.
AU - Gayer-Anderson, C.
AU - Jones, P.B.
AU - Jongsma, H.E.
AU - Kirkbride, J.B.
AU - Simons, Claudia
AU - van Winkel, Ruud
AU - EU-GEI High Risk Study
PY - 2021/8
Y1 - 2021/8
N2 - Important questions remain about the profile of cognitive impairment in psychotic disorders across adulthood and illness stages. The age-associated profile of familial impairments also remains unclear, as well as the effect of factors, such as symptoms, functioning, and medication. Using cross-sectional data from the EU-GEI and GROUP studies, comprising 8455 participants aged 18 to 65, we examined cognitive functioning across adulthood in patients with psychotic disorders (n = 2883), and their unaffected siblings (n = 2271), compared to controls (n = 3301). An abbreviated WAIS-III measured verbal knowledge, working memory, visuospatial processing, processing speed, and IQ. Patients showed medium to large deficits across all functions (ES range = -0.45 to -0.73, p < 0.001), while siblings showed small deficits on IQ, verbal knowledge, and working memory (ES = -0.14 to -0.33, p < 0.001). Magnitude of impairment was not associated with participant age, such that the size of impairment in older and younger patients did not significantly differ. However, first-episode patients performed worse than prodromal patients (ES range = -0.88 to -0.60, p < 0.001). Adjusting for cannabis use, symptom severity, and global functioning attenuated impairments in siblings, while deficits in patients remained statistically significant, albeit reduced by half (ES range = -0.13 to -0.38, p < 0.01). Antipsychotic medication also accounted for around half of the impairment in patients (ES range = -0.21 to -0.43, p < 0.01). Deficits in verbal knowledge, and working memory may specifically index familial, i.e., shared genetic and/or shared environmental, liability for psychotic disorders. Nevertheless, potentially modifiable illness-related factors account for a significant portion of the cognitive impairment in psychotic disorders.
AB - Important questions remain about the profile of cognitive impairment in psychotic disorders across adulthood and illness stages. The age-associated profile of familial impairments also remains unclear, as well as the effect of factors, such as symptoms, functioning, and medication. Using cross-sectional data from the EU-GEI and GROUP studies, comprising 8455 participants aged 18 to 65, we examined cognitive functioning across adulthood in patients with psychotic disorders (n = 2883), and their unaffected siblings (n = 2271), compared to controls (n = 3301). An abbreviated WAIS-III measured verbal knowledge, working memory, visuospatial processing, processing speed, and IQ. Patients showed medium to large deficits across all functions (ES range = -0.45 to -0.73, p < 0.001), while siblings showed small deficits on IQ, verbal knowledge, and working memory (ES = -0.14 to -0.33, p < 0.001). Magnitude of impairment was not associated with participant age, such that the size of impairment in older and younger patients did not significantly differ. However, first-episode patients performed worse than prodromal patients (ES range = -0.88 to -0.60, p < 0.001). Adjusting for cannabis use, symptom severity, and global functioning attenuated impairments in siblings, while deficits in patients remained statistically significant, albeit reduced by half (ES range = -0.13 to -0.38, p < 0.01). Antipsychotic medication also accounted for around half of the impairment in patients (ES range = -0.21 to -0.43, p < 0.01). Deficits in verbal knowledge, and working memory may specifically index familial, i.e., shared genetic and/or shared environmental, liability for psychotic disorders. Nevertheless, potentially modifiable illness-related factors account for a significant portion of the cognitive impairment in psychotic disorders.
KW - ability
KW - childhood
KW - decline
KW - deficits
KW - episode
KW - genetic risk
KW - impairment
KW - reliability
KW - schizophrenia-patients
KW - validity
KW - EPISODE
KW - RELIABILITY
KW - SCHIZOPHRENIA-PATIENTS
KW - CHILDHOOD
KW - IMPAIRMENT
KW - DECLINE
KW - GENETIC RISK
KW - ABILITY
KW - DEFICITS
KW - VALIDITY
U2 - 10.1038/s41380-020-00969-z
DO - 10.1038/s41380-020-00969-z
M3 - Article
C2 - 33414498
SN - 1359-4184
VL - 26
SP - 4529
EP - 4543
JO - Molecular Psychiatry
JF - Molecular Psychiatry
IS - 8
ER -