Josephine Mollon1,2, Anthony S David1, Stanley Zammit3,4, Glyn Lewis5, Abraham Reichenberg1,6,7,8. 1. Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, England. 2. currently with the Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut. 3. Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, Wales. 4. Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, England. 5. Division of Psychiatry, Faculty of Brain Sciences, University College London, London, England. 6. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York. 7. Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. 8. Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
Abstract
Importance: Most patients with psychotic disorders experience severe cognitive impairment, but the onset and course of this impairment remain unclear. Moreover, the course of cognitive functions in other psychiatric conditions remains largely unexamined. Objective: To chart the course of general and specific cognitive functions in individuals with psychotic disorders, psychotic experiences, and depression. Design, Setting, and Participants: The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective cohort study comprising all live births between April 1, 1991, and December 31, 1992, in Avon, England. The dates of analysis were September 2015 to July 2016. Participants who underwent cognitive testing at ages 18 months and 4, 8, 15, and 20 years and psychiatric assessment at age 18 years were included. Main Outcomes and Measures: Individuals with psychotic disorder, psychosis with depression, psychotic experiences, and depression were compared with controls. Outcomes were full-scale, verbal, and nonverbal IQ at ages 18 months and 4, 8, 15, and 20 years, as well as measures of processing speed, working memory, language, visuospatial ability, and attention at ages 8 and 20 years. Results: The following numbers of individuals were available for analyses in this longitudinal birth cohort study: 511 (238 male [46.6%]) at age 18 months (mean [SD] age, 1.53 [0.03] years), 483 (229 male [47.4%]) at age 4 years (mean [SD] age, 4.07 [0.03] years), 3930 (1679 male [42.7%]) at age 8 years (mean [SD] age, 8.65 [0.29] years), 3783 (1686 male [44.6%]) at age 15 years (mean [SD] age, 15.45 [0.27] years), and 257 (90 male [35.0%]) at age 20 years (mean [SD] age, 20.06 [0.55] years). Individuals with psychotic disorder showed continually increasing deficits between infancy (18 months) and adulthood (20 years) in full-scale IQ (effect size of change [ESΔ] = -1.09, P = .02) and nonverbal IQ (ESΔ = -0.94, P = .008). The depression group showed a small, increasing deficit in nonverbal IQ (ESΔ = -0.29, P = .04) between infancy and adulthood. Between ages 8 and 20 years, the psychotic disorder group exhibited developmental lags (ie, slower growth) in measures of processing speed (ESΔ = -0.68, P = .001), working memory (ESΔ = -0.59, P = .004), and attention (ESΔ = -0.44, P = .001) and large, static deficits in measures of language (ES = -0.87, P = .005) and visuospatial ability (ES = -0.90, P = .001). There was only weak evidence for cognitive deficits in the psychosis with depression group and the psychotic experiences group. Conclusions and Relevance: The findings herein suggest that the origins of psychotic disorder involve dynamic developmental processes, affecting both verbal and nonverbal abilities throughout the first 2 decades of life and leading to increasing dysfunction. These developmental processes do not manifest in other psychiatric disorders, such as psychosis with depression and depression.
Importance: Most patients with psychotic disorders experience severe cognitive impairment, but the onset and course of this impairment remain unclear. Moreover, the course of cognitive functions in other psychiatric conditions remains largely unexamined. Objective: To chart the course of general and specific cognitive functions in individuals with psychotic disorders, psychotic experiences, and depression. Design, Setting, and Participants: The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective cohort study comprising all live births between April 1, 1991, and December 31, 1992, in Avon, England. The dates of analysis were September 2015 to July 2016. Participants who underwent cognitive testing at ages 18 months and 4, 8, 15, and 20 years and psychiatric assessment at age 18 years were included. Main Outcomes and Measures: Individuals with psychotic disorder, psychosis with depression, psychotic experiences, and depression were compared with controls. Outcomes were full-scale, verbal, and nonverbal IQ at ages 18 months and 4, 8, 15, and 20 years, as well as measures of processing speed, working memory, language, visuospatial ability, and attention at ages 8 and 20 years. Results: The following numbers of individuals were available for analyses in this longitudinal birth cohort study: 511 (238 male [46.6%]) at age 18 months (mean [SD] age, 1.53 [0.03] years), 483 (229 male [47.4%]) at age 4 years (mean [SD] age, 4.07 [0.03] years), 3930 (1679 male [42.7%]) at age 8 years (mean [SD] age, 8.65 [0.29] years), 3783 (1686 male [44.6%]) at age 15 years (mean [SD] age, 15.45 [0.27] years), and 257 (90 male [35.0%]) at age 20 years (mean [SD] age, 20.06 [0.55] years). Individuals with psychotic disorder showed continually increasing deficits between infancy (18 months) and adulthood (20 years) in full-scale IQ (effect size of change [ESΔ] = -1.09, P = .02) and nonverbal IQ (ESΔ = -0.94, P = .008). The depression group showed a small, increasing deficit in nonverbal IQ (ESΔ = -0.29, P = .04) between infancy and adulthood. Between ages 8 and 20 years, the psychotic disorder group exhibited developmental lags (ie, slower growth) in measures of processing speed (ESΔ = -0.68, P = .001), working memory (ESΔ = -0.59, P = .004), and attention (ESΔ = -0.44, P = .001) and large, static deficits in measures of language (ES = -0.87, P = .005) and visuospatial ability (ES = -0.90, P = .001). There was only weak evidence for cognitive deficits in the psychosis with depression group and the psychotic experiences group. Conclusions and Relevance: The findings herein suggest that the origins of psychotic disorder involve dynamic developmental processes, affecting both verbal and nonverbal abilities throughout the first 2 decades of life and leading to increasing dysfunction. These developmental processes do not manifest in other psychiatric disorders, such as psychosis with depression and depression.
Authors: Ruben C Gur; Monica E Calkins; Theodore D Satterthwaite; Kosha Ruparel; Warren B Bilker; Tyler M Moore; Adam P Savitt; Hakon Hakonarson; Raquel E Gur Journal: JAMA Psychiatry Date: 2014-04 Impact factor: 21.596
Authors: Larry J Seidman; Daniel I Shapiro; William S Stone; Kristen A Woodberry; Ashley Ronzio; Barbara A Cornblatt; Jean Addington; Carrie E Bearden; Kristin S Cadenhead; Tyrone D Cannon; Daniel H Mathalon; Thomas H McGlashan; Diana O Perkins; Ming T Tsuang; Elaine F Walker; Scott W Woods Journal: JAMA Psychiatry Date: 2016-12-01 Impact factor: 21.596
Authors: Abigail Fraser; Corrie Macdonald-Wallis; Kate Tilling; Andy Boyd; Jean Golding; George Davey Smith; John Henderson; John Macleod; Lynn Molloy; Andy Ness; Susan Ring; Scott M Nelson; Debbie A Lawlor Journal: Int J Epidemiol Date: 2012-04-16 Impact factor: 7.196
Authors: Andy Boyd; Jean Golding; John Macleod; Debbie A Lawlor; Abigail Fraser; John Henderson; Lynn Molloy; Andy Ness; Susan Ring; George Davey Smith Journal: Int J Epidemiol Date: 2012-04-16 Impact factor: 7.196
Authors: Camilla Jerlang Christiani; Jens R M Jepsen; Anne Thorup; Nicoline Hemager; Ditte Ellersgaard; Katrine S Spang; Birgitte K Burton; Maja Gregersen; Anne Søndergaard; Aja N Greve; Ditte L Gantriis; Gry Poulsen; Md Jamal Uddin; Larry J Seidman; Ole Mors; Kerstin J Plessen; Merete Nordentoft Journal: Schizophr Bull Date: 2019-10-24 Impact factor: 9.306
Authors: Josephine Mollon; Samuel R Mathias; Emma E M Knowles; Amanda Rodrigue; Marinka M G Koenis; Godfrey D Pearlson; Abraham Reichenberg; Jennifer Barrett; Dominique Denbow; Katrina Aberizk; Molly Zatony; Russell A Poldrack; John Blangero; David C Glahn Journal: Psychol Med Date: 2019-01-04 Impact factor: 7.723
Authors: Paolo Fusar-Poli; Christoph U Correll; Celso Arango; Michael Berk; Vikram Patel; John P A Ioannidis Journal: World Psychiatry Date: 2021-06 Impact factor: 79.683
Authors: Josephine Mollon; Emma E M Knowles; Samuel R Mathias; Ruben Gur; Juan Manuel Peralta; Daniel J Weiner; Elise B Robinson; Raquel E Gur; John Blangero; Laura Almasy; David C Glahn Journal: Mol Psychiatry Date: 2018-10-19 Impact factor: 15.992