BACKGROUND: Improving neurocognitive abilities is a treatment priority in schizophrenia, however, pharmacological efforts to enhance deficits after illness onset have resulted in quite modest results that are of questionable clinical meaningfulness. Individuals at clinical risk for psychosis demonstrate neurocognitive impairments intermediate to the level of deficits observed in schizophrenia and normative performance, suggesting that a similar magnitude of improvement might result in more clinically meaningful change. In this study, we examined neurocognitive changes after six months of treatment in adolescents with clinical signs of risk for psychosis. METHODS: Adolescents who were referred to the Recognition and Prevention program, which is focused on treatment and research for individuals at a clinical high risk for psychosis, were followed in a naturalistic treatment design. At study entry and approximately six months after starting treatment, we examined neuropsychological functioning and clinical symptoms for patients who remained off medications (OFF; N=27), started selective serotonin reuptake inhibitor antidepressant medication (AD; N=15), or started a second-generation antipsychotic medication (AP; N=11) within three months of study entry. We also included a locally recruited healthy comparison group (HC; N=17). RESULTS: The clinical groups were not significantly different on baseline demographic, neurocognitive, or clinical symptom measures. Linear mixed models were used to examine cognitive changes, with time between assessments, depressive symptom severity, and attenuated positive symptom severity as random effects. Group by time effects were observed in sustained attention and verbal learning, with the AD group showing a more favorable response than the AP group. The AD group's improvements were not significantly different from the HC or OFF group. CONCLUSION: Early intervention for those at clinical high risk for psychosis may result in neurocognitive improvements. These improvements were observed for those prescribed antidepressant, but not antipsychotic medications even though the groups did not differ in clinical symptom severity or treatment response.
BACKGROUND: Improving neurocognitive abilities is a treatment priority in schizophrenia, however, pharmacological efforts to enhance deficits after illness onset have resulted in quite modest results that are of questionable clinical meaningfulness. Individuals at clinical risk for psychosis demonstrate neurocognitive impairments intermediate to the level of deficits observed in schizophrenia and normative performance, suggesting that a similar magnitude of improvement might result in more clinically meaningful change. In this study, we examined neurocognitive changes after six months of treatment in adolescents with clinical signs of risk for psychosis. METHODS: Adolescents who were referred to the Recognition and Prevention program, which is focused on treatment and research for individuals at a clinical high risk for psychosis, were followed in a naturalistic treatment design. At study entry and approximately six months after starting treatment, we examined neuropsychological functioning and clinical symptoms for patients who remained off medications (OFF; N=27), started selective serotonin reuptake inhibitor antidepressant medication (AD; N=15), or started a second-generation antipsychotic medication (AP; N=11) within three months of study entry. We also included a locally recruited healthy comparison group (HC; N=17). RESULTS: The clinical groups were not significantly different on baseline demographic, neurocognitive, or clinical symptom measures. Linear mixed models were used to examine cognitive changes, with time between assessments, depressive symptom severity, and attenuated positive symptom severity as random effects. Group by time effects were observed in sustained attention and verbal learning, with the AD group showing a more favorable response than the AP group. The AD group's improvements were not significantly different from the HC or OFF group. CONCLUSION: Early intervention for those at clinical high risk for psychosis may result in neurocognitive improvements. These improvements were observed for those prescribed antidepressant, but not antipsychotic medications even though the groups did not differ in clinical symptom severity or treatment response.
Authors: U Gschwandtner; J Aston; S Borgwardt; M Drewe; C Feinendegen; D Lacher; A Lanzarone; R-D Stieglitz; A Riecher-Rössler Journal: Acta Psychiatr Scand Date: 2003-08 Impact factor: 6.392
Authors: K A Hawkins; J Addington; R S E Keefe; B Christensen; D O Perkins; R Zipurksy; S W Woods; T J Miller; E Marquez; A Breier; T H McGlashan Journal: Schizophr Res Date: 2004-04-01 Impact factor: 4.939
Authors: Tandy J Miller; Thomas H McGlashan; Joanna L Rosen; Kristen Cadenhead; Tyrone Cannon; Joseph Ventura; William McFarlane; Diana O Perkins; Godfrey D Pearlson; Scott W Woods Journal: Schizophr Bull Date: 2003 Impact factor: 9.306
Authors: Barbara A Cornblatt; Todd Lencz; Christopher W Smith; Christoph U Correll; Andrea M Auther; Emilie Nakayama Journal: Schizophr Bull Date: 2003 Impact factor: 9.306
Authors: Tandy J Miller; Thomas H McGlashan; Joanna Lifshey Rosen; Lubna Somjee; Philip J Markovich; Kelly Stein; Scott W Woods Journal: Am J Psychiatry Date: 2002-05 Impact factor: 18.112
Authors: Jeroen A J Schmitt; Johannes G Ramaekers; Monique J Kruizinga; Martin P J van Boxtel; Eric F P M Vuurman; Wim J Riedel Journal: J Psychopharmacol Date: 2002-09 Impact factor: 4.153
Authors: Lorraine E Wolf; Barbara A Cornblatt; Simone A Roberts; Barbara Maminski Shapiro; L Erlenmeyer-Kimling Journal: Schizophr Res Date: 2002-10-01 Impact factor: 4.939
Authors: Christian Kohler; Karin E Borgmann-Winter; Irene Hurford; Eli Neustadter; James Yi; Monica E Calkins Journal: Curr Psychiatry Rep Date: 2014-04 Impact factor: 5.285
Authors: Jordina Tor; Montserrat Dolz; Anna Sintes; Daniel Muñoz; Marta Pardo; Elena de la Serna; Olga Puig; Gisela Sugranyes; Inmaculada Baeza Journal: Eur Child Adolesc Psychiatry Date: 2017-09-15 Impact factor: 4.785