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General intelligence in adult patients with early- and adult-onset schizophrenia
- T. Calkova, L. Mørch-Johnsen, R. Elle Smelror, K. Nordbø Jørgensen, S. Cervenka, K. Collste, A. Vaskinn, A. Margrethe Myhre, O. A. Andreassen, T. Ueland, I. Agartz, D. Andreou
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S490-S491
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Introduction
Early-onset schizophrenia (EOS) is a relatively uncommon disorder with psychotic symptoms emerging before 18 years of age. Although still under debate, EOS may be a more severe disorder relative to adult-onset schizophrenia (AOS), with worse prognosis. Cognitive deficits are a core feature of schizophrenia, accounting for a large part of the detrimental effect of the disorder and may reflect underlying neurodevelopmental disturbances. Some but not all previous studies show that the magnitude of cognitive deficits, including intelligence quotient (IQ), in patients with schizophrenia is dependent on the age of onset.
ObjectivesWe aimed to assess IQ in adult patients with EOS and AOS, and healthy controls. We hypothesized that patients with EOS would show lower IQ than those with AOS, and both patient groups lower IQ than HC.
MethodsWe included 136 adult patients with EOS (mean age: 24.7 (7.7) years, mean duration of illness: 9.3 (8.5) years, 50% women), 382 patients with AOS (mean age: 32.4 (9.5) years, mean duration of illness: 5.7 (6.6) years, 40.1% women) and 896 adult healthy controls (mean age: 33.2 (9.2) years, 47.1% women). We assessed current IQ with the Wechsler Abbreviated Scale of Intelligence (WASI) which yielded verbal (VIQ), performance (PIQ) and full-scale IQ (FIQ) scores. In a post-hoc analysis, we estimated premorbid IQ using the National Adult Reading Test (NART). We applied analyses of covariance (ANCOVAs) to investigate the putative differences in IQ scores and IQ change between patients with EOS, patients with AOS and healthy controls.
ResultsIn sex-, and age-adjusted models, FIQ and PIQ, but not VIQ, were significantly lower in EOS than in AOS (p=0.03, p<0.001 and p=0.428, respectively) (Image). Patients with EOS had fewer years of education than patients with AOS (p<0.001); the PIQ but not the FIQ difference between EOS and AOS remained significant after adjustment for education years (p=0.016 and p=0.333, respectively). Both patient groups had significantly lower IQ scores than healthy controls (Image). Further, patients with EOS and patients with AOS did not significantly differ in estimated premorbid IQ (109 and 110 units, respectively, p=0.092), whereas patients with EOS had a significantly larger estimated IQ decline after the disease onset compared to patients with AOS (12 and 9 units decline, respectively, p=0.015).
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ConclusionsOur findings show that adult patients with EOS have significantly lower PIQ and FIQ scores, and significantly larger IQ decline after the disease onset, but not lower premorbid IQ, compared to patients with AOS. The adolescent onset of psychotic symptoms is linked, as expected, to fewer total years of education, which appears to explain the lower FIQ but only partially the lower PIQ in EOS, which may thereby be linked to the disorder per se.
Disclosure of InterestT. Calkova: None Declared, L. Mørch-Johnsen: None Declared, R. Elle Smelror: None Declared, K. Nordbø Jørgensen: None Declared, S. Cervenka: None Declared, K. Collste: None Declared, A. Vaskinn: None Declared, A. Margrethe Myhre: None Declared, O. A. Andreassen Consultant of: HealthLytix, Speakers bureau of: Lundbeck and Sunovion, T. Ueland: None Declared, I. Agartz: None Declared, D. Andreou: None Declared
Enigma-collaborative Analyses of Neuroimaging eop Data: What have we Achieved?
- I. Agartz, V. Lonning, R. Smelror, M. Lundberg, T. Edbom, T.P. Gurholt
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- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S60
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Introduction
The ENIGMA-EOP collaboration aims to identify structural phenotypic markers that robustly discriminate adolescents with early-onset psychosis (EOP) from healthy controls through mega- or meta-analysis of magnetic resonance imaging (MR) data. Through larger samples we will obtain sufficient power to detect the brain structural correlates, overcome some of the clinical heterogeneity and characterize the developmental trajectories.
MethodsMultiple linear regression was used to investigate structural brain differences in two Scandinavian adolescent EOP cohorts (altogether 50 patients; ages 12.1-18.3 years (mean 16.4 years), 60% female; 68 controls; ages 12.0-18.8 years (mean 16.2 years), 62% female) acquired on two different 3 T GE MRI scanners. The statistical analysis included site as a covariate in addition to age, sex and intracranial volume (ICV). The results are presented by p-values, Cohens's-d effect size and with an indication of directionality. MRI scans were processed following the ENIGMA (http://enigma.ini.usc.edu/) structural image processing protocols using FreeSurfer (Fischl 2012) version 5.3.0 to measure subcortical brain volumes.
ResultsPreliminary results show significant or trend-significant group effects on right amygdala (P = 0.001, d = 0.33, patients < controls), total grey matter volume (P = 0.037, d = 0.21, patients < controls), ICV (P = 0.028, d = 0.22, patients < controls) and third ventricle (P = 0.067, d = 0.19, patients > controls). Sub-analyses in the two individual groups show overlapping findings in right amygdala. Previously reported enlarged lateral and 4th ventricles, and caudate, from a similar Scandinavian adolescent EOP cohort (Juuhl-Langseth, 2012) were not replicated.
ConclusionThere is a need for larger subject samples in EOP to better capture disease mechanisms. Research groups interested in participating can join ENIGMA-EOP through: http://enigma.ini.usc.edu/ongoing/enigma-eop-working-group/.
Disclosure of interestThe authors have not supplied their declaration of competing interest.