Neuropsychological evidence for abnormal neurodevelopment associated with early-onset psychoses

• Published in: Psychological medicine Vol. 43; no. 4; pp. 757 - 768
• Main Authors: Bombin, I., Mayoral, M., Castro-Fornieles, J., Gonzalez-Pinto, A., de la Serna, E., Rapado-Castro, M., Barbeito, S., Parellada, M., Baeza, I., Graell, M., Payá, B., Arango, C.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.04.2013
• Subjects: Adolescent; Adult; Age; Age of Onset; Analysis of Variance; Attention - physiology; Biological and medical sciences; Bipolar Disorder - complications; Bipolar Disorder - physiopathology; Case-Control Studies; Child; Children & youth; Cognition & reasoning; Cognition Disorders - complications; Cognition Disorders - physiopathology; Cognitive impairment; Developmental Disabilities - complications; Developmental Disabilities - physiopathology; Developmental psychology; Early onset; Executive Function - physiology; Female; First time; Follow-Up Studies; Humans; Learning - physiology; Male; Medical sciences; Memory - physiology; Mental disorders; Neuropsychological Tests - statistics & numerical data; Neuropsychology; Original Articles; Psychiatric Status Rating Scales - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Psychotic Disorders - complications; Psychotic Disorders - physiopathology; Psychotic symptoms; Schizophrenia - complications; Schizophrenia - physiopathology; Schizophrenic Psychology; Working memory; Cognition; neurodevelopmental hypothesis; longitudinal design; psychosis; Psychosis; Age of onset; Follow up study; Early
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291712001535

The longitudinal neuropsychological study of first-episode early-onset psychosis (EOP) patients, whose brain maturation is still in progress at the time of illness onset, provides a unique opportunity to compare their cognitive development with that of healthy subjects, in search of specific patterns resulting from the interaction between neurodevelopmental processes and the presence of psychotic disorders. Method Seventy-five first-episode EOP patients (schizophrenia n = 35; bipolar disorder n = 17; other forms of psychosis n = 23) with a mean age of 15.53 years were assessed with a neuropsychological battery that included measures of attention, working memory, memory and executive functions within 6 months following the onset of the first psychotic symptom (baseline) and 2 years later. Psychotic symptoms were assessed at both times with the Positive and Negative Symptom Scale (PANSS). Seventy-nine healthy subjects matched for age and education served as controls. EOP patients showed significant cognitive impairment at both baseline and the 2-year follow-up, with no significant differences between diagnostic groups at either time. Both healthy controls and EOP patients improved in all cognitive measures, except for patient working memory. Improvement in patient attention lost significance after controlling for psychotic symptom reduction. No significant time/diagnosis interaction was found among patients (p > 0.405). Cognitive impairment in EOP is already present at the first episode, and cognitive development seems to be arrested early in EOP patients compared to their healthy peers, at least for some cognitive functions. These and previous similar results support the neurodevelopmental hypothesis of psychosis.