Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-16T14:09:44.278Z Has data issue: false hasContentIssue false
  • English
  • Français

Cognitive impairment from early to middle adulthood in patients with affective and nonaffective psychotic disorders

Published online by Cambridge University Press:  04 January 2019

Josephine Mollon ,
Samuel R. Mathias ,
Emma E. M. Knowles ,
Amanda Rodrigue ,
Marinka M. G. Koenis ,
Godfrey D. Pearlson ,
Abraham Reichenberg ,
Jennifer Barrett ,
Dominique Denbow  and
Katrina Aberizk
...Show all authors
Josephine Mollon*
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
Samuel R. Mathias
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
Emma E. M. Knowles
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
Amanda Rodrigue
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
Marinka M. G. Koenis
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
Godfrey D. Pearlson
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
Abraham Reichenberg
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA
Jennifer Barrett
Affiliation:
Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
Dominique Denbow
Affiliation:
Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
Katrina Aberizk
Affiliation:
Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
Molly Zatony
Affiliation:
Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
Russell A. Poldrack
Affiliation:
Department of Psychology, Stanford University, Stanford, CA, USA
John Blangero
Affiliation:
South Texas Diabetes and Obesity Institute and Department of Human Genetics, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
David C. Glahn
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
*
Author for correspondence: Josephine Mollon, E-mail: josephine.mollon@yale.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Cognitive impairment is a core feature of psychotic disorders, but the profile of impairment across adulthood, particularly in African-American populations, remains unclear.

Methods

Using cross-sectional data from a case–control study of African-American adults with affective (n = 59) and nonaffective (n = 68) psychotic disorders, we examined cognitive functioning between early and middle adulthood (ages 20–60) on measures of general cognitive ability, language, abstract reasoning, processing speed, executive function, verbal memory, and working memory.

Results

Both affective and nonaffective psychosis patients showed substantial and widespread cognitive impairments. However, comparison of cognitive functioning between controls and psychosis groups throughout early (ages 20–40) and middle (ages 40–60) adulthood also revealed age-associated group differences. During early adulthood, the nonaffective psychosis group showed increasing impairments with age on measures of general cognitive ability and executive function, while the affective psychosis group showed increasing impairment on a measure of language ability. Impairments on other cognitive measures remained mostly stable, although decreasing impairments on measures of processing speed, memory and working memory were also observed.

Conclusions

These findings suggest similarities, but also differences in the profile of cognitive dysfunction in adults with affective and nonaffective psychotic disorders. Both affective and nonaffective patients showed substantial and relatively stable impairments across adulthood. The nonaffective group also showed increasing impairments with age in general and executive functions, and the affective group showed an increasing impairment in verbal functions, possibly suggesting different underlying etiopathogenic mechanisms.

Keywords

Life-spanneuropsychologypsychosisschizophreniatrajectory
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 1 , January 2020 , pp. 48 - 57
Copyright
Copyright © Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addington, J and Addington, D (1993) Premorbid functioning, cognitive functioning, symptoms and outcome in schizophrenia. Journal of Psychiatry and Neuroscience 18, 18.Google Scholar
Akaike, H. (1992). Information theory and an extension of the maximum likelihood principle. In Breakthroughs in statistics. Springer, New York, NY, pp. 610–624.Google Scholar
Albus, M, Hubmann, W, Scherer, J, Dreikorn, B, Hecht, S, Sobizack, N and Mohr, F (2002) A prospective 2-year follow-up study of neurocognitive functioning in patients with first-episode schizophrenia. European Archives of Psychiatry and Clinical Neuroscience 252, 262–267.Google Scholar
Aleman, A, Hijman, R, de Haan, EH and Kahn, RS (1999) Memory impairment in schizophrenia: a meta-analysis. American Journal of Psychiatry 156, 1358–1366.Google Scholar
Benedetti, A and Abrahamowicz, M (2004) Using generalized additive models to reduce residual confounding. Statistics in Medicine 23, 3781–3801.Google Scholar
Benjamini, Y and Yekutieli, D (2001) The control of the false discovery rate in multiple testing under dependency. Annals of Statistics 29, 1165–1188.Google Scholar
Bilder, RM, Lipschutz-Broch, L, Reiter, G, Geisler, SH, Mayerhoff, DI and Lieberman, JA (1992) Intellectual deficits in first-episode schizophrenia: evidence for progressive deterioration. Schizophrenia Bulletin 18, 437.Google Scholar
Bonner-Jackson, A, Grossman, LS, Harrow, M and Rosen, C (2010) Neurocognition in schizophrenia: a 20-year multi-follow-up of the course of processing speed and stored knowledge. Comprehensive Psychiatry 51, 471–479.Google Scholar
Bora, E, Yucel, M and Pantelis, C (2009) Cognitive functioning in schizophrenia, schizoaffective disorder and affective psychoses: meta-analytic study. British Journal of Psychiatry 195, 475–482.Google Scholar
Bozikas, VP and Andreou, C (2011) Longitudinal studies of cognition in first episode psychosis: a systematic review of the literature. Australian and New Zealand Journal of Psychiatry 45, 93–108.Google Scholar
Brissos, S, Dias, VV, Balanza-Martinez, V, Carita, AI and Figueira, ML (2011) Symptomatic remission in schizophrenia patients: relationship with social functioning, quality of life, and neurocognitive performance. Schizophrenia Research 129, 133–136.Google Scholar
Buckley, PF, Miller, BJ, Lehrer, DS and Castle, DJ (2008) Psychiatric comorbidities and schizophrenia. Schizophrenia Bulletin 35, 383–402.Google Scholar
Burdick, KE, Goldberg, JF, Harrow, M, Faull, RN and Malhotra, AK (2006) Neurocognition as a stable endophenotype in bipolar disorder and schizophrenia. The Journal of Nervous and Mental Disease 194, 255–260.Google Scholar
Buuren, SV and Fredriks, M (2001) Worm plot: a simple diagnostic device for modelling growth reference curves. Statistics in Medicine 20, 1259–1277.Google Scholar
Cassano, GB, Pini, S, Saettoni, M, Rucci, P and Dell'Osso, L (1998) Occurrence and clinical correlates of psychiatric comorbidity in patients with psychotic disorders. The Journal of Clinical Psychiatry 59, 60–68.Google Scholar
Chen, EY, Lam, L, Chen, R, Nguyen, D and Chan, C (1996) Prefrontal neuropsychological impairment and illness duration in schizophrenia: a study of 204 patients in Hong Kong. Acta Psychiatrica Scandinavica 93, 144–150.Google Scholar
Cohen, J (1992) A power primer. Psychological Bulletin 112, 155.Google Scholar
Czaja, SJ, Charness, N, Fisk, AD, Hertzog, C, Nair, SN, Rogers, WA and Sharit, J (2006) Factors predicting the use of technology: findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE). Psychology and Aging 21, 333–352.Google Scholar
D'Souza, MS and Markou, A (2012) Schizophrenia and tobacco smoking comorbidity: nAChR agonists in the treatment of schizophrenia-associated cognitive deficits. Neuropharmacology 62, 1564–1573.Google Scholar
Davidson, M, Harvey, PD, Powchik, P and Parrella, M (1995) Severity of symptoms in chronically institutionalized geriatric schizophrenic patients. The American journal of psychiatry 152, 197.Google Scholar
Davidson, M, Reichenberg, A, Rabinowitz, J, Weiser, M, Kaplan, Z and Mark, M (1999) Behavioral and intellectual markers for schizophrenia in apparently healthy male adolescents. American Journal of Psychiatry 156, 1328–1335.Google Scholar
Deary, IJ, Corley, J, Gow, AJ, Harris, SE, Houlihan, LM, Marioni, RE, Penke, L, Rafnsson, SB and Starr, JM (2009) Age-associated cognitive decline. British medical bulletin 92, 135–152.Google Scholar
Fett, AK, Viechtbauer, W, Dominguez, MD, Penn, DL, van Os, J and Krabbendam, L (2011) The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: a meta-analysis. Neuroscience & Biobehavioral Reviews 35, 573–588.Google Scholar
Fioravanti, M, Carlone, O, Vitale, B, Cinti, ME and Clare, L (2005) A meta-analysis of cognitive deficits in adults with a diagnosis of schizophrenia. Neuropsychology Review 15, 73–95.Google Scholar
First, MB, Spitzer, RL, Gibbon, M and Williams, JB (2002) Structured clinical interview for DSM-IV-TR axis I disorders, research version Patient Edition. SCID-I/P.Google Scholar
Fleming, SK, Blasey, C and Schatzberg, AF (2004) Neuropsychological correlates of psychotic features in major depressive disorders: a review and meta-analysis. Journal of Psychiatric Research 38, 27–35.Google Scholar
Friedman, JI, Harvey, PD, Coleman, T, Moriarty, PJ, Bowie, C, Parrella, M, White, L, Adler, D and Davis, KL (2001) Six-year follow-up study of cognitive and functional status across the lifespan in schizophrenia: a comparison with Alzheimer's disease and normal aging. American Journal of Psychiatry 158, 1441–1448.Google Scholar
Fucetola, R, Seidman, LJ, Kremen, WS, Faraone, SV, Goldstein, JM and Tsuang, MT (2000) Age and neuropsychologic function in schizophrenia: a decline in executive abilities beyond that observed in healthy volunteers. Biological Psychiatry 48, 137–146.Google Scholar
Gallego, JA, Bonetti, J, Zhang, J, Kane, JM and Correll, CU (2012) Prevalence and correlates of antipsychotic polypharmacy: a systematic review and meta-regression of global and regional trends from the 1970s to 2009. Schizophrenia Research 138, 18–28.Google Scholar
Glahn, DC, Bearden, CE, Cakir, S, Barrett, JA, Najt, P, Serap Monkul, E, Maples, N, Velligan, DI and Soares, JC (2006) Differential working memory impairment in bipolar disorder and schizophrenia: effects of lifetime history of psychosis. Bipolar Disorders 8, 117–123.Google Scholar
Glahn, DC, Bearden, CE, Barguil, M, Barrett, J, Reichenberg, A, Bowden, CL, Soares, JC and Velligan, DI (2007) The neurocognitive signature of psychotic bipolar disorder. Biological Psychiatry 62, 910–916.Google Scholar
Gooding, DC and Tallent, KA (2002) Spatial working memory performance in patients with schizoaffective psychosis versus schizophrenia: a tale of two disorders? Schizophrenia Research 53, 209–218.Google Scholar
Green, MF, Kern, RS, Braff, DL and Mintz, J (2000) Neurocognitive deficits and functional outcome in schizophrenia. Schizophrenia Bulletin 26, 119–136.Google Scholar
Gur, RE, Cowell, P, Turetsky, BI, Gallacher, F, Cannon, T, Bilker, W and Gur, RC (1998) A follow-up magnetic resonance imaging study of schizophrenia: relationship of neuroanatomical changes to clinical and neurobehavioral measures. Archives of General Psychiatry 55, 145–152.Google Scholar
Gur, RC, Calkins, ME, Satterthwaite, TD, Ruparel, K, Bilker, WB, Moore, TM, Savitt, AP, Hakonarson, H and Gur, RE (2014) Neurocognitive growth charting in psychosis spectrum youths. JAMA Psychiatry 71, 366–374.Google Scholar
Hall, RC (1995) Global assessment of functioning: a modified scale. Psychosomatics 36, 267–275.Google Scholar
Hartshorne, JK and Germine, LT (2015) When does cognitive functioning peak? The asynchronous rise and fall of different cognitive abilities across the life span. Psychological Science 26, 433–443.Google Scholar
Harvey, PD, Silverman, JM, Mohs, RC, Parrella, M, White, L, Powchik, P, Davidson, M and Davis, KL (1999) Cognitive decline in late-life schizophrenia: a longitudinal study of geriatric chronically hospitalized patients. Biological Psychiatry 45, 32–40.Google Scholar
Heilbronner, U, Samara, M, Leucht, S, Falkai, P and Schulze, TG (2016) The longitudinal course of schizophrenia across the lifespan: clinical, cognitive, and neurobiological aspects. Harvard Review of Psychiatry 24, 118–128.Google Scholar
Hill, SK, Schuepbach, D, Herbener, ES, Keshavan, MS and Sweeney, JA (2004) Pretreatment and longitudinal studies of neuropsychological deficits in antipsychotic-naıve patients with schizophrenia. Schizophrenia Research 68, 49–63.Google Scholar
Hyde, TM, Nawroz, S, Goldberg, TE, Bigelow, LB, Strong, D, Ostrem, JL, Weinberger, DR and Kleinman, JE (1994) Is there cognitive decline in schizophrenia? A cross-sectional study. The British Journal of Psychiatry 164, 494–500.Google Scholar
Jones, P, Murray, R, Jones, P, Rodgers, B and Marmot, M (1994) Child developmental risk factors for adult schizophrenia in the British 1946 birth cohort. The Lancet 344, 1398–1402.Google Scholar
Levinson, DF, Mowry, BJ, Escamilla, MA and Faraone, SV (2002) The Lifetime Dimensions of Psychosis Scale (LDPS): description and interrater reliability. Schizophrenia Bulletin 28, 683–695.Google Scholar
Lin, X and Zhang, D (1999) Inference in generalized additive mixed models by using smoothing splines. Journal of the Royal Statistical Society: Series B (Statistical Methodology) 61, 381–400.Google Scholar
Løberg, E-M and Hugdahl, K (2009) Cannabis use and cognition in schizophrenia. Frontiers in Human Neuroscience 3, 53–61.Google Scholar
MacCabe, JH, Wicks, S, Lofving, S, David, AS, Berndtsson, A, Gustafsson, JE, Allebeck, P and Dalman, C (2013) Decline in cognitive performance between ages 13 and 18 years and the risk for psychosis in adulthood: a Swedish longitudinal cohort study in males. JAMA Psychiatry 70, 261–270.Google Scholar
Mathias, SR, Knowles, EEM, Barrett, J, Leach, O, Buccheri, S, Beetham, T, Blangero, J, Poldrack, RA and Glahn, DC (2017) The processing-speed impairment in psychosis is more than just accelerated aging. Schizophrenia Bulletin 43, 814–823.Google Scholar
Mathias, SR, Knowles, EEM, Barrett, J, Beetham, T, Leach, O, Buccheri, S, Aberizk, K, Blangero, J, Poldrack, RA and Glahn, DC (2018) Deficits in visual working-memory capacity and general cognition in African Americans with psychosis. Schizophrenia Research 193, 100–106.Google Scholar
McGurk, SR, Mueser, KT, DeRosa, TJ and Wolfe, R (2009) Work, recovery, and comorbidity in schizophrenia: a randomized controlled trial of cognitive remediation. Schizophrenia Bulletin 35, 319–335.Google Scholar
Meier, MH, Caspi, A, Reichenberg, A, Keefe, RS, Fisher, HL, Harrington, H, Houts, R, Poulton, R and Moffitt, TE (2013) Neuropsychological decline in schizophrenia from the premorbid to the postonset period: evidence from a population-representative longitudinal study. American Journal of Psychiatry 171, 91–101.Google Scholar
Mockler, D, Riordan, J and Sharma, T (1997) Memory and intellectual deficits do not decline with age in schizophrenia. Schizophrenia Research 26, 1–7.Google Scholar
Mohamed, S, Paulsen, JS, O'leary, D, Arndt, S and Andreasen, N (1999) Generalized cognitive deficits in schizophrenia: a study of first-episode patients. Archives of General Psychiatry 56, 749–754.Google Scholar
Mojtabai, R, Bromet, EJ, Harvey, PD, Carlson, GA, Craig, TJ and Fennig, S (2000) Neuropsychological differences between first-admission schizophrenia and psychotic affective disorders. American Journal of Psychiatry 157, 1453–1460.Google Scholar
Mollon, J, David, AS, Zammit, S, Lewis, G and Reichenberg, A (2018) Course of cognitive development from infancy to early adulthood in the psychosis spectrum. JAMA Psychiatry 75, 270–279.Google Scholar
Mueser, KT, Bellack, AS and Blanchard, JJ (1992) Comorbidity of schizophrenia and substance abuse: Implications for treatment. Journal of Consulting and Clinical Psychology 60, 845.Google Scholar
O'Leary, DS, Flaum, M, Kesler, ML, Flashman, LA, Arndt, S and Andreasen, NC (2000) Cognitive correlates of the negative, disorganized, and psychotic symptom dimensions of schizophrenia. The Journal of Neuropsychiatry and Clinical Neurosciences 12, 4–15.Google Scholar
Pencer, A and Addington, J (2003) Substance use and cognition in early psychosis. Journal of Psychiatry and Neuroscience 28, 48.Google Scholar
Pirkola, T, Tuulio-Henriksson, A, Glahn, D, Kieseppa, T, Haukka, J, Kaprio, J, Lonnqvist, J and Cannon, TD (2005) Spatial working memory function in twins with schizophrenia and bipolar disorder. Biological Psychiatry 58, 930–936.Google Scholar
R Development Core Team (2008) R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing.Google Scholar
Rajji, TK and Mulsant, BH (2008) Nature and course of cognitive function in late-life schizophrenia: a systematic review. Schizophrenia Research 102, 122–140.Google Scholar
Reichenberg, A and Harvey, PD (2007) Neuropsychological impairments in schizophrenia: integration of performance-based and brain imaging findings. Psychological Bulletin 133, 833–858.Google Scholar
Reichenberg, A, Harvey, PD, Bowie, CR, Mojtabai, R, Rabinowitz, J, Heaton, RK and Bromet, E (2009) Neuropsychological function and dysfunction in schizophrenia and psychotic affective disorders. Schizophrenia Bulletin 35, 1022–1029.Google Scholar
Salthouse, T. A. (2009). When does age-related cognitive decline begin? Neurobiology of Aging 30, 507–514.Google Scholar
Samamé, C, Martino, DJ and Strejilevich, SA (2014) Longitudinal course of cognitive deficits in bipolar disorder: a meta-analytic study. Journal of Affective Disorders 164, 130–138.Google Scholar
Schatzberg, AF, Posener, JA, DeBattista, C, Kalehzan, BM, Rothschild, AJ and Shear, PK (2000) Neuropsychological deficits in psychotic versus nonpsychotic major depression and no mental illness. American Journal of Psychiatry 157, 1095–1100.Google Scholar
Schwarz, G (1978) Estimating the dimension of a model. The Annals of Statistics 6, 461–464.Google Scholar
Seidman, LJ, Buka, SL, Goldstein, JM and Tsuang, MT (2006) Intellectual decline in schizophrenia: evidence from a prospective birth cohort 28 year follow-up study. Journal of Clinical and Experimental Neuropsychology 28, 225–242.Google Scholar
Siman-Tov, T, Bosak, N, Sprecher, E, Paz, R, Eran, A, Aharon-Peretz, J and Kahn, I (2016) Early age-related functional connectivity decline in high-order cognitive networks. Frontiers in Aging Neuroscience 8, 330.Google Scholar
Singh-Manoux, A, Kivimaki, M, Glymour, MM, Elbaz, A, Berr, C, Ebmeier, KP, Ferrie, JE and Dugravot, A (2012) Timing of onset of cognitive decline: results from Whitehall II prospective cohort study. BMJ 344, d7622.Google Scholar
Smith, PL (1979) Splines as a useful and convenient statistical tool. The American Statistician 33, 57–62.Google Scholar
Stahl, S and Grady, M (2004) A critical review of atypical antipsychotic utilization: comparing monotherapy with polypharmacy and augmentation. Current Medicinal Chemistry 11, 313–327.Google Scholar
Szöke, A, Trandafir, A, Dupont, M-E, Méary, A, Schürhoff, F and Leboyer, M (2008) Longitudinal studies of cognition in schizophrenia: meta-analysis. The British Journal of Psychiatry 192, 248–257.Google Scholar
Vorstman, JA, Breetvelt, EJ, Duijff, SN, Eliez, S, Schneider, M, Jalbrzikowski, M, Armando, M, Vicari, S, Shashi, V, Hooper, SR, Chow, EW, Fung, WL, Butcher, NJ, Young, DA, McDonald-McGinn, DM, Vogels, A, van Amelsvoort, T, Gothelf, D, Weinberger, R, Weizman, A, Klaassen, PW, Koops, S, Kates, WR, Antshel, KM, Simon, TJ, Ousley, OY, Swillen, A, Gur, RE, Bearden, CE, Kahn, RS and Bassett, AS and for the International Consortium on, B. & Behavior in 22q11.2 Deletion, S (2015) Cognitive decline preceding the onset of psychosis in patients with 22q11.2 deletion syndrome. JAMA Psychiatry 72, 377–385.Google Scholar
Yucel, M, Bora, E, Lubman, DI, Solowij, N, Brewer, WJ, Cotton, SM, Conus, P, Takagi, MJ, Fornito, A, Wood, SJ, McGorry, PD and Pantelis, C (2012) The impact of cannabis use on cognitive functioning in patients with schizophrenia: a meta-analysis of existing findings and new data in a first-episode sample. Schizophrenia Bulletin 38, 316–330.Google Scholar
Zanelli, J, Reichenberg, A, Morgan, K, Fearon, P, Kravariti, E, Dazzan, P, Morgan, C, Zanelli, C, Demjaha, A and Jones, PB (2010) Specific and generalized neuropsychological deficits: a comparison of patients with various first-episode psychosis presentations. American Journal of Psychiatry 167, 78–85.Google Scholar
Supplementary material: PDF

Mollon et al. supplementary material

Mollon et al. supplementary material
Download Mollon et al. supplementary material(PDF)
PDF 2.9 MB