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Published Online: 1 August 2011

Impact of Neurocognition on Social and Role Functioning in Individuals at Clinical High Risk for Psychosis

Ricardo E. Carrión, Ph.D., Terry E. Goldberg, Ph.D., Danielle McLaughlin, M.A., Andrea M. Auther, Ph.D., Christoph U. Correll, M.D., and Barbara A. Cornblatt, Ph.D., M.B.A.Authors Info & Affiliations

Publication: American Journal of Psychiatry

Volume 168, Number 8

https://doi.org/10.1176/appi.ajp.2011.10081209

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Abstract

Objective:

Cognitive deficits have been well documented in schizophrenia and have been shown to impair quality of life and to compromise everyday functioning. Recent studies of adolescents and young adults at high risk for developing psychosis show that neurocognitive impairments are detectable before the onset of psychotic symptoms. However, it remains unclear how cognitive impairments affect functioning before the onset of psychosis. The authors assessed cognitive impairment in adolescents at clinical high risk for psychosis and examined its impact on social and role functioning.

Method:

A sample of 127 treatment-seeking patients at clinical high risk for psychosis and a group of 80 healthy comparison subjects were identified and recruited for research in the Recognition and Prevention Program. At baseline, participants were assessed with a comprehensive neurocognitive battery as well as measures of social and role functioning.

Results:

Relative to healthy comparison subjects, clinical high-risk patients showed significant impairments in the domains of processing speed, verbal memory, executive function, working memory, visuospatial processing, motor speed, sustained attention, and language. Clinical high-risk patients also displayed impaired social and role functioning at baseline. Among patients with attenuated positive symptoms, processing speed was related to social and role functioning at baseline.

Conclusions:

These findings demonstrate that cognitive and functional impairments are detectable in patients at clinical high risk for psychosis before the onset of psychotic illness and that processing speed appears to be an important cognitive predictor of poor functioning.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry

Go to American Journal of Psychiatry

American Journal of Psychiatry

Volume 168 • Number 8 • August 2011

Pages: 806 - 813

PubMed: 21536691

History

Received: 26 August 2010

Revision received: 6 January 2011

Accepted: 14 February 2011

Published online: 1 August 2011

Published in print: August 2011

Authors

Details

Ricardo E. Carrión, Ph.D.

From the Department of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System; and the Department of Psychiatry, Albert Einstein College of Medicine, Bronx, N.Y.

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Terry E. Goldberg, Ph.D.

From the Department of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System; and the Department of Psychiatry, Albert Einstein College of Medicine, Bronx, N.Y.

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Danielle McLaughlin, M.A.

From the Department of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System; and the Department of Psychiatry, Albert Einstein College of Medicine, Bronx, N.Y.

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Andrea M. Auther, Ph.D.

From the Department of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System; and the Department of Psychiatry, Albert Einstein College of Medicine, Bronx, N.Y.

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Christoph U. Correll, M.D.

From the Department of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System; and the Department of Psychiatry, Albert Einstein College of Medicine, Bronx, N.Y.

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Barbara A. Cornblatt, Ph.D., M.B.A.

From the Department of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System; and the Department of Psychiatry, Albert Einstein College of Medicine, Bronx, N.Y.

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Notes

Address correspondence and reprint requests to Dr. Carrión, Zucker Hillside Hospital, Psychiatry Research, 75-59 263rd St., Glen Oaks, NY 11004; [email protected] (e-mail).

Funding Information

Dr. Goldberg has received consulting fees from Merck and GlaxoSmithKline and receives royalties for use of the Brief Assessment of Cognition in Schizophrenia in clinical trials. Dr. Correll has been a consultant or adviser to or received grant support or honoraria from Actelion, AstraZeneca, Boehringer-Ingelheim, Bristol-Myers Squibb, Cephalon, Eli Lilly, Feinstein Institute for Medical Research, IntraCellular Therapies, GlaxoSmithKline, Hoffmann-La Roche, Lundbeck, Medicure, Merck, NARSAD, NIMH, Ortho-McNeill/Janssen/Johnson & Johnson, Otsuka, Pfizer, Schering-Plough, Sepracor/Sunovion, Supernus, Takeda, and Vanda. Dr. Cornblatt was the original developer of the Continuous Performance Test, Identical Pairs Version, and has been an adviser to Merck and Bristol-Myers Squibb. The other authors report no financial relationships with commercial interests.Supported by NIMH grants MH61523-02 and MH61523-8 (to Dr. Cornblatt) and the Zucker Hillside Hospital NIMH Advanced Center for Intervention and Services Research for the Study of Schizophrenia grant MH 074543-01 (to John M. Kane, M.D.).

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