Prevalence of cognitive impairments and strengths in the early course of psychosis and depression

PRONIA Consortium; PRONIA Consortium

doi:10.1017/S0033291723001770

Prevalence of cognitive impairments and strengths in the early course of psychosis and depression

PRONIA Consortium
, PRONIA Consortium

Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia.; Orygen, the National Centre of Excellence for Youth Mental Health, Melbourne, Victoria, Australia.
Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
Faculty of Psychology and Educational Sciences, Department of Psychology, Ludwig-Maximilian University, Munich, Germany.
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
Scientific Institute, IRCCS E. Medea, Pasian di Prato, Udine, Italy.
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
Department of Psychology, Woodbourne Priory Hospital, Birmingham, UK.
Department of Translational Biomedicine and Neuroscience (DiBraiN) – University of Bari “Aldo Moro”, Bari, Italy
Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
Department of Psychiatry, University Psychiatric Clinic, Psychiatric University Hospital, University of Basel, Basel, Switzerland
Medical Faculty, University of Basel, Basel, 4051, Switzerland
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, 40629, Germany
Department of Psychiatry, University of Turku, Turku, 20700, Finland
Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health , Carlton, VIC , Australia
Department of Psychiatry (UPK), University of Basel, Basel, Switzerland; Institute for Translational Psychiatry, University of Münster, Münster, Germany
Department of Child Adolescent Psychiatry and Psychotherapy, University of Münster, Münster, Germany.
Birmingham Early Intervention Service, Birmingham Women's and Children NHS Foundation Trust, Birmingham, UK.
Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Centre for Applied Psychology, School of Psychology, University of Birmingham, Edgbaston, United Kingdom

Research output: Contribution to journal › Article › peer-review

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Abstract

Background Studies investigating cognitive impairments in psychosis and depression have typically compared the average performance of the clinical group against healthy controls (HC), and do not report on the actual prevalence of cognitive impairments or strengths within these clinical groups. This information is essential so that clinical services can provide adequate resources to supporting cognitive functioning. Thus, we investigated this prevalence in individuals in the early course of psychosis or depression. Methods A comprehensive cognitive test battery comprising 12 tests was completed by 1286 individuals aged 15-41 (mean age 25.07, s.d. 5.88) from the PRONIA study at baseline: HC (N = 454), clinical high risk for psychosis (CHR; N = 270), recent-onset depression (ROD; N = 267), and recent-onset psychosis (ROP; N = 295). Z-scores were calculated to estimate the prevalence of moderate or severe deficits or strengths (>2 s.d. or 1-2 s.d. below or above HC, respectively) for each cognitive test. Results Impairment in at least two cognitive tests was as follows: ROP (88.3% moderately, 45.1% severely impaired), CHR (71.2% moderately, 22.4% severely impaired), ROD (61.6% moderately, 16.2% severely impaired). Across clinical groups, impairments were most prevalent in tests of working memory, processing speed, and verbal learning. Above average performance (>1 s.d.) in at least two tests was present for 40.5% ROD, 36.1% CHR, 16.1% ROP, and was >2 SDs in 1.8% ROD, 1.4% CHR, and 0% ROP. Conclusions These findings suggest that interventions should be tailored to the individual, with working memory, processing speed, and verbal learning likely to be important transdiagnostic targets.

Original language	English
Pages (from-to)	5945-5957
Number of pages	13
Journal	Psychological Medicine
Volume	53
Issue number	13
Early online date	6 Jul 2023
DOIs	https://doi.org/10.1017/S0033291723001770
Publication status	Published - Oct 2023

Bibliographical note

Copyright © The Author(s), 2023. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence
(http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Funding Information: PRONIA is a Collaborative Project funded by the European Union under the 7th Framework Programme under grant agreement n° 602152 Funding Information: CP: Participated on Advisory Boards for Janssen-Cilag, AstraZeneca, Lundbeck, and Servier. Received honoraria for talks presented at educational meetings organised by AstraZeneca, Janssen-Cilag, Eli Lilly, Pfizer, Lundbeck, and Shire. NK and RS: Received honoraria for talks presented at education meetings organised by Otsuka/Lundbeck. RU: Received grants from the Medical Research Council, National Institute for Health Research: Health Technology Assessment, European Commission – Research: The Seventh Framework Programme, and personal speaker fees from Sunovion, outside the submitted work. TL: Supported by the Koeln Fortune Program/Faculty of Medicine, University of Cologne (Grant No. 370/2020). JW: Partly supported by the NARSAD Young Investigator Award of LK through the Brain & Behavior Research Foundation (grant number 28474). KA: Supported by a Dame Kate Campbell Fellowship from the University of Melbourne.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Mental health
verbal learning
processing speed
working memory
psychosis

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10.1017/S0033291723001770Licence: CC BY 4.0

Staintonetal_2023_VoR
Copyright © The Author(s), 2023. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Final published version, 471 KBLicence: CC BY 4.0

Cite this

@article{34f8eacca2f54fbca81bb3413ff5ed6a,

title = "Prevalence of cognitive impairments and strengths in the early course of psychosis and depression",

abstract = "Background Studies investigating cognitive impairments in psychosis and depression have typically compared the average performance of the clinical group against healthy controls (HC), and do not report on the actual prevalence of cognitive impairments or strengths within these clinical groups. This information is essential so that clinical services can provide adequate resources to supporting cognitive functioning. Thus, we investigated this prevalence in individuals in the early course of psychosis or depression. Methods A comprehensive cognitive test battery comprising 12 tests was completed by 1286 individuals aged 15-41 (mean age 25.07, s.d. 5.88) from the PRONIA study at baseline: HC (N = 454), clinical high risk for psychosis (CHR; N = 270), recent-onset depression (ROD; N = 267), and recent-onset psychosis (ROP; N = 295). Z-scores were calculated to estimate the prevalence of moderate or severe deficits or strengths (>2 s.d. or 1-2 s.d. below or above HC, respectively) for each cognitive test. Results Impairment in at least two cognitive tests was as follows: ROP (88.3\% moderately, 45.1\% severely impaired), CHR (71.2\% moderately, 22.4\% severely impaired), ROD (61.6\% moderately, 16.2\% severely impaired). Across clinical groups, impairments were most prevalent in tests of working memory, processing speed, and verbal learning. Above average performance (>1 s.d.) in at least two tests was present for 40.5\% ROD, 36.1\% CHR, 16.1\% ROP, and was >2 SDs in 1.8\% ROD, 1.4\% CHR, and 0\% ROP. Conclusions These findings suggest that interventions should be tailored to the individual, with working memory, processing speed, and verbal learning likely to be important transdiagnostic targets.",

keywords = "Mental health, verbal learning, processing speed, working memory, psychosis",

author = "Alexandra Stainton and Katharine Chisholm and Griffiths, \{Si{\^a}n Lowri\} and Lana Kambeitz-Ilankovic and Julian Wenzel and Carolina Bonivento and Paolo Brambilla and Mariam Iqbal and Lichtenstein, \{Theresa K\} and Marlene Rosen and Antonucci, \{Linda A\} and Eleonora Maggioni and Joseph Kambeitz and Stefan Borgwardt and Anita Riecher-R{\"o}ssler and Christina Andreou and Andr{\'e} Schmidt and Frauke Schultze-Lutter and Eva Meisenzahl and Stephan Ruhrmann and Salokangas, \{Raimo K R\} and Christos Pantelis and Rebekka Lencer and Georg Romer and Alessandro Bertolino and Rachel Upthegrove and Nikolaos Koutsouleris and Kelly Allott and Wood, \{Stephen J\} and \{PRONIA Consortium\} and \{PRONIA Consortium\}",

note = "Copyright {\textcopyright} The Author(s), 2023. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. Funding Information: PRONIA is a Collaborative Project funded by the European Union under the 7th Framework Programme under grant agreement n° 602152 Funding Information: CP: Participated on Advisory Boards for Janssen-Cilag, AstraZeneca, Lundbeck, and Servier. Received honoraria for talks presented at educational meetings organised by AstraZeneca, Janssen-Cilag, Eli Lilly, Pfizer, Lundbeck, and Shire. NK and RS: Received honoraria for talks presented at education meetings organised by Otsuka/Lundbeck. RU: Received grants from the Medical Research Council, National Institute for Health Research: Health Technology Assessment, European Commission – Research: The Seventh Framework Programme, and personal speaker fees from Sunovion, outside the submitted work. TL: Supported by the Koeln Fortune Program/Faculty of Medicine, University of Cologne (Grant No. 370/2020). JW: Partly supported by the NARSAD Young Investigator Award of LK through the Brain \& Behavior Research Foundation (grant number 28474). KA: Supported by a Dame Kate Campbell Fellowship from the University of Melbourne.",

year = "2023",

month = oct,

doi = "10.1017/S0033291723001770",

language = "English",

volume = "53",

pages = "5945--5957",

journal = "Psychological Medicine",

issn = "0033-2917",

publisher = "Cambridge University Press",

number = "13",

}

TY - JOUR

T1 - Prevalence of cognitive impairments and strengths in the early course of psychosis and depression

AU - Stainton, Alexandra

AU - Chisholm, Katharine

AU - Griffiths, Siân Lowri

AU - Kambeitz-Ilankovic, Lana

AU - Wenzel, Julian

AU - Bonivento, Carolina

AU - Brambilla, Paolo

AU - Iqbal, Mariam

AU - Lichtenstein, Theresa K

AU - Rosen, Marlene

AU - Antonucci, Linda A

AU - Maggioni, Eleonora

AU - Kambeitz, Joseph

AU - Borgwardt, Stefan

AU - Riecher-Rössler, Anita

AU - Andreou, Christina

AU - Schmidt, André

AU - Schultze-Lutter, Frauke

AU - Meisenzahl, Eva

AU - Ruhrmann, Stephan

AU - Salokangas, Raimo K R

AU - Pantelis, Christos

AU - Lencer, Rebekka

AU - Romer, Georg

AU - Bertolino, Alessandro

AU - Upthegrove, Rachel

AU - Koutsouleris, Nikolaos

AU - Allott, Kelly

AU - Wood, Stephen J

AU - PRONIA Consortium

N1 - Copyright © The Author(s), 2023. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. Funding Information: PRONIA is a Collaborative Project funded by the European Union under the 7th Framework Programme under grant agreement n° 602152 Funding Information: CP: Participated on Advisory Boards for Janssen-Cilag, AstraZeneca, Lundbeck, and Servier. Received honoraria for talks presented at educational meetings organised by AstraZeneca, Janssen-Cilag, Eli Lilly, Pfizer, Lundbeck, and Shire. NK and RS: Received honoraria for talks presented at education meetings organised by Otsuka/Lundbeck. RU: Received grants from the Medical Research Council, National Institute for Health Research: Health Technology Assessment, European Commission – Research: The Seventh Framework Programme, and personal speaker fees from Sunovion, outside the submitted work. TL: Supported by the Koeln Fortune Program/Faculty of Medicine, University of Cologne (Grant No. 370/2020). JW: Partly supported by the NARSAD Young Investigator Award of LK through the Brain & Behavior Research Foundation (grant number 28474). KA: Supported by a Dame Kate Campbell Fellowship from the University of Melbourne.

PY - 2023/10

Y1 - 2023/10

N2 - Background Studies investigating cognitive impairments in psychosis and depression have typically compared the average performance of the clinical group against healthy controls (HC), and do not report on the actual prevalence of cognitive impairments or strengths within these clinical groups. This information is essential so that clinical services can provide adequate resources to supporting cognitive functioning. Thus, we investigated this prevalence in individuals in the early course of psychosis or depression. Methods A comprehensive cognitive test battery comprising 12 tests was completed by 1286 individuals aged 15-41 (mean age 25.07, s.d. 5.88) from the PRONIA study at baseline: HC (N = 454), clinical high risk for psychosis (CHR; N = 270), recent-onset depression (ROD; N = 267), and recent-onset psychosis (ROP; N = 295). Z-scores were calculated to estimate the prevalence of moderate or severe deficits or strengths (>2 s.d. or 1-2 s.d. below or above HC, respectively) for each cognitive test. Results Impairment in at least two cognitive tests was as follows: ROP (88.3% moderately, 45.1% severely impaired), CHR (71.2% moderately, 22.4% severely impaired), ROD (61.6% moderately, 16.2% severely impaired). Across clinical groups, impairments were most prevalent in tests of working memory, processing speed, and verbal learning. Above average performance (>1 s.d.) in at least two tests was present for 40.5% ROD, 36.1% CHR, 16.1% ROP, and was >2 SDs in 1.8% ROD, 1.4% CHR, and 0% ROP. Conclusions These findings suggest that interventions should be tailored to the individual, with working memory, processing speed, and verbal learning likely to be important transdiagnostic targets.

AB - Background Studies investigating cognitive impairments in psychosis and depression have typically compared the average performance of the clinical group against healthy controls (HC), and do not report on the actual prevalence of cognitive impairments or strengths within these clinical groups. This information is essential so that clinical services can provide adequate resources to supporting cognitive functioning. Thus, we investigated this prevalence in individuals in the early course of psychosis or depression. Methods A comprehensive cognitive test battery comprising 12 tests was completed by 1286 individuals aged 15-41 (mean age 25.07, s.d. 5.88) from the PRONIA study at baseline: HC (N = 454), clinical high risk for psychosis (CHR; N = 270), recent-onset depression (ROD; N = 267), and recent-onset psychosis (ROP; N = 295). Z-scores were calculated to estimate the prevalence of moderate or severe deficits or strengths (>2 s.d. or 1-2 s.d. below or above HC, respectively) for each cognitive test. Results Impairment in at least two cognitive tests was as follows: ROP (88.3% moderately, 45.1% severely impaired), CHR (71.2% moderately, 22.4% severely impaired), ROD (61.6% moderately, 16.2% severely impaired). Across clinical groups, impairments were most prevalent in tests of working memory, processing speed, and verbal learning. Above average performance (>1 s.d.) in at least two tests was present for 40.5% ROD, 36.1% CHR, 16.1% ROP, and was >2 SDs in 1.8% ROD, 1.4% CHR, and 0% ROP. Conclusions These findings suggest that interventions should be tailored to the individual, with working memory, processing speed, and verbal learning likely to be important transdiagnostic targets.

KW - Mental health

KW - verbal learning

KW - processing speed

KW - working memory

KW - psychosis

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DO - 10.1017/S0033291723001770

M3 - Article

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SN - 0033-2917

VL - 53

SP - 5945

EP - 5957

JO - Psychological Medicine

JF - Psychological Medicine

IS - 13

ER -

Prevalence of cognitive impairments and strengths in the early course of psychosis and depression

Abstract

Bibliographical note

UN SDGs

Keywords

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