Neurocognitive Assessments Are More Important Among Adolescents Than Adults for Predicting Psychosis in Clinical High Risk

  • TianHong Zhang
    Correspondence
    Address correspondence to TianHong Zhang, M.D., Ph.D.
    Affiliations
    Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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  • HuiRu Cui
    Affiliations
    Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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  • YanYan Wei
    Affiliations
    Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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  • XiaoChen Tang
    Affiliations
    Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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  • LiHua Xu
    Affiliations
    Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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  • YeGang Hu
    Affiliations
    Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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  • YingYing Tang
    Affiliations
    Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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  • Tao Chen
    Affiliations
    Big Data Research Laboratory, University of Waterloo, Waterloo, Ontario, Canada

    Senior Research Fellow, Labor and Worklife Program, Harvard University, Cambridge, Massachusetts

    Niacin (Shanghai) Technology Co, Ltd, Shanghai, China
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  • ChunBo Li
    Affiliations
    Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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  • JiJun Wang
    Correspondence
    JiJun Wang, M.D., Ph.D.
    Affiliations
    Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China

    CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China

    Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
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      Abstract

      Background

      Few studies have examined the effects of age on neurocognition to predict conversion to psychosis in individuals at clinical high risk (CHR). This study aimed to compare the extent and predictive performance of cognitive deficits between adolescents and adults at CHR.

      Methods

      A comprehensive neuropsychological battery was performed on 325 CHR individuals and 365 healthy control (HC) subjects. The subjects were first divided into 189 CHR adolescents (age 12−17 years), 136 CHR adults (age 18−45 years), 88 HC adolescents, and 277 HC adults. CHR subjects were then divided into converters (CHR-Cs) (adolescents, n = 43; adults, n = 34) and nonconverters (CHR-NCs) (adolescents, n = 146; adults, n = 102) based on their 2-year follow-up clinical status.

      Results

      The adolescents and adults at CHR performed significantly worse than their control groups on all neurocognitive tests, except for performance on the continuous performance test in adolescents. In the comparison between adolescents and adults, patterns of neurocognitive deficits seemed to vary in HC subjects rather than in CHR subjects. In the comparison between CHR and HC subjects, the rank order of effect sizes across the neurocognitive tests was similar for the top two tests of symbol coding and verbal learning. Comparison between CHR-Cs and CHR-NCs revealed that adolescent CHR-Cs performed significantly worse than CHR-NCs on seven of eight neurocognitive tests; however, adult CHR-Cs performed significantly worse than CHR-NCs only in the visuospatial memory test.

      Conclusions

      The role of neurocognitive dysfunction may have different patterns and weights during the onset of psychosis in adolescents and adults at CHR, implicating the development of specific strategies that could monitor and improve cognitive function in CHR adolescents.

      Keywords

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