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Neurocognitive growth charting in psychosis spectrum youths.
JAMA Psychiatry. 2014 Apr; 71(4):366-74.JP

Abstract

IMPORTANCE

Psychosis-risk studies have examined help-seeking adolescents and young adults. Population-based studies evaluating psychotic symptoms and neurocognitive performance across childhood are needed for "growth charting" cognitive development. We hypothesized that psychosis spectrum youths have delayed neurocognitive age relative to chronological age. We expected larger lags with increased symptom severity and in late adolescence and early adulthood.

OBJECTIVES

To examine neurocognitive age and compare typically developing participants with psychosis spectrum participants.

DESIGN, SETTING, AND PARTICIPANTS

The Philadelphia Neurodevelopmental Cohort is a genotyped sample, with electronic medical records, enrolled in the study of brain behavior. In an academic and children's hospital health care network, a structured psychiatric evaluation was performed and a computerized neurocognitive battery administered to evaluate performance in several domains. From 18,344 youths in the recruitment pool who were aged 8 to 21 years, physically and cognitively capable of participating, and proficient in English, participants were randomly selected with stratification for age, sex, and ethnicity. A total of 9138 participants were enrolled in the study between November 1, 2009, and November 30, 2011, and 2321 endorsed psychotic symptoms: 1423 significant (psychosis spectrum) and 898 limited (psychosis limited). They had no comorbid medical conditions. They were compared with 981 participants endorsing significant other psychiatric symptoms and with 1963 typically developing children with no psychiatric or medical disorders.

MAIN OUTCOMES AND MEASURES

The computerized neurocognitive battery provides accuracy and speed measures on 12 tests and speed measures alone on 2, yielding 26 measures used in a regression analysis to predict chronological age. Prediction was performed on the entire set and separately for each domain (executive, episodic memory, complex cognition, social cognition, and sensorimotor speed).

RESULTS

Throughout childhood and adolescence, the psychosis spectrum group had lower predicted age compared with the typically developing group and the group with other psychiatric symptoms. The psychosis spectrum group had a greater developmental lag than the psychosis limited group. The lags were most pronounced for complex cognition and social cognition and were smallest for sensorimotor speed.

CONCLUSIONS AND RELEVANCE

Individuals who endorse psychotic symptoms are neurocognitively delayed across the age range; this delay relates to symptom severity and is not prominent in other psychiatric disorders. Combined clinical and neurocognitive assessment can facilitate early detection and targeted intervention to delay or ameliorate disease progression.

Authors+Show Affiliations

Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.Department of Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24499990

Citation

Gur, Ruben C., et al. "Neurocognitive Growth Charting in Psychosis Spectrum Youths." JAMA Psychiatry, vol. 71, no. 4, 2014, pp. 366-74.
Gur RC, Calkins ME, Satterthwaite TD, et al. Neurocognitive growth charting in psychosis spectrum youths. JAMA Psychiatry. 2014;71(4):366-74.
Gur, R. C., Calkins, M. E., Satterthwaite, T. D., Ruparel, K., Bilker, W. B., Moore, T. M., Savitt, A. P., Hakonarson, H., & Gur, R. E. (2014). Neurocognitive growth charting in psychosis spectrum youths. JAMA Psychiatry, 71(4), 366-74. https://doi.org/10.1001/jamapsychiatry.2013.4190
Gur RC, et al. Neurocognitive Growth Charting in Psychosis Spectrum Youths. JAMA Psychiatry. 2014;71(4):366-74. PubMed PMID: 24499990.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neurocognitive growth charting in psychosis spectrum youths. AU - Gur,Ruben C, AU - Calkins,Monica E, AU - Satterthwaite,Theodore D, AU - Ruparel,Kosha, AU - Bilker,Warren B, AU - Moore,Tyler M, AU - Savitt,Adam P, AU - Hakonarson,Hakon, AU - Gur,Raquel E, PY - 2014/2/7/entrez PY - 2014/2/7/pubmed PY - 2014/5/20/medline SP - 366 EP - 74 JF - JAMA psychiatry JO - JAMA Psychiatry VL - 71 IS - 4 N2 - IMPORTANCE: Psychosis-risk studies have examined help-seeking adolescents and young adults. Population-based studies evaluating psychotic symptoms and neurocognitive performance across childhood are needed for "growth charting" cognitive development. We hypothesized that psychosis spectrum youths have delayed neurocognitive age relative to chronological age. We expected larger lags with increased symptom severity and in late adolescence and early adulthood. OBJECTIVES: To examine neurocognitive age and compare typically developing participants with psychosis spectrum participants. DESIGN, SETTING, AND PARTICIPANTS: The Philadelphia Neurodevelopmental Cohort is a genotyped sample, with electronic medical records, enrolled in the study of brain behavior. In an academic and children's hospital health care network, a structured psychiatric evaluation was performed and a computerized neurocognitive battery administered to evaluate performance in several domains. From 18,344 youths in the recruitment pool who were aged 8 to 21 years, physically and cognitively capable of participating, and proficient in English, participants were randomly selected with stratification for age, sex, and ethnicity. A total of 9138 participants were enrolled in the study between November 1, 2009, and November 30, 2011, and 2321 endorsed psychotic symptoms: 1423 significant (psychosis spectrum) and 898 limited (psychosis limited). They had no comorbid medical conditions. They were compared with 981 participants endorsing significant other psychiatric symptoms and with 1963 typically developing children with no psychiatric or medical disorders. MAIN OUTCOMES AND MEASURES: The computerized neurocognitive battery provides accuracy and speed measures on 12 tests and speed measures alone on 2, yielding 26 measures used in a regression analysis to predict chronological age. Prediction was performed on the entire set and separately for each domain (executive, episodic memory, complex cognition, social cognition, and sensorimotor speed). RESULTS: Throughout childhood and adolescence, the psychosis spectrum group had lower predicted age compared with the typically developing group and the group with other psychiatric symptoms. The psychosis spectrum group had a greater developmental lag than the psychosis limited group. The lags were most pronounced for complex cognition and social cognition and were smallest for sensorimotor speed. CONCLUSIONS AND RELEVANCE: Individuals who endorse psychotic symptoms are neurocognitively delayed across the age range; this delay relates to symptom severity and is not prominent in other psychiatric disorders. Combined clinical and neurocognitive assessment can facilitate early detection and targeted intervention to delay or ameliorate disease progression. SN - 2168-6238 UR - https://www.unboundmedicine.com/medline/citation/24499990/Neurocognitive_growth_charting_in_psychosis_spectrum_youths_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2013.4190 DB - PRIME DP - Unbound Medicine ER -