Generalized neurocognitive impairment in individuals at ultra‐high risk for psychosis: The possible key role of slowed processing speed

Abstract Objective Widespread neurocognitive impairment is well‐established in individuals at ultra‐high risk (UHR) for developing psychoses, but it is unknown whether slowed processing speed may underlie impairment in other neurocognitive domains, as found in schizophrenia. The study delineated dom...

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Main Authors: Lasse Randers, Jens Richardt Møllegaard Jepsen, Birgitte Fagerlund, Dorte Nordholm, Kristine Krakauer, Carsten Hjorthøj, Birte Glenthøj, Merete Nordentoft
Format: Article
Language:English
Published: Wiley 2021-03-01
Series:Brain and Behavior
Subjects:
Online Access:https://doi.org/10.1002/brb3.1962
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author Lasse Randers
Jens Richardt Møllegaard Jepsen
Birgitte Fagerlund
Dorte Nordholm
Kristine Krakauer
Carsten Hjorthøj
Birte Glenthøj
Merete Nordentoft
author_facet Lasse Randers
Jens Richardt Møllegaard Jepsen
Birgitte Fagerlund
Dorte Nordholm
Kristine Krakauer
Carsten Hjorthøj
Birte Glenthøj
Merete Nordentoft
author_sort Lasse Randers
collection DOAJ
description Abstract Objective Widespread neurocognitive impairment is well‐established in individuals at ultra‐high risk (UHR) for developing psychoses, but it is unknown whether slowed processing speed may underlie impairment in other neurocognitive domains, as found in schizophrenia. The study delineated domain functioning in a UHR sample and examined if neurocognitive slowing might account for deficits across domains. Methods The cross‐sectional study included 50 UHR individuals with no (n = 38) or minimal antipsychotic exposure (n = 12; mean lifetime dose of haloperidol equivalent = 17.56 mg; SD = 13.04) and 50 matched healthy controls. Primary analyses compared group performance across neurocognitive domains before and after covarying for processing speed. To examine the specificity of processing speed effects, post hoc analyses examined the impact of the other neurocognitive domains and intelligence as covariates. Results UHR individuals exhibited significant impairment across all neurocognitive domains (all ps ≤ .010), with medium to large effect sizes (Cohen's ds = −0.53 to −1.12). Only processing speed used as covariate eliminated significant between‐group differences in all other domains, reducing unadjusted Cohen's d values with 68% on average, whereas the other domains used as covariates averagely reduced unadjusted Cohen's d values with 20% to 48%. When covarying each of the other domains after their shared variance with speed of processing was removed, all significant between‐group domain differences remained (all ps ≤ .024). Conclusion Slowed processing speed may underlie generalized neurocognitive impairment in UHR individuals and represent a potential intervention target.
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spelling doaj.art-332e81dbf8fe4b33b36d3db500b99bf42022-12-21T22:22:10ZengWileyBrain and Behavior2162-32792021-03-01113n/an/a10.1002/brb3.1962Generalized neurocognitive impairment in individuals at ultra‐high risk for psychosis: The possible key role of slowed processing speedLasse Randers0Jens Richardt Møllegaard Jepsen1Birgitte Fagerlund2Dorte Nordholm3Kristine Krakauer4Carsten Hjorthøj5Birte Glenthøj6Merete Nordentoft7Copenhagen Research Center for Mental Health ‐ CORE Mental Health Center Copenhagen Copenhagen University Hospital Copenhagen DenmarkCopenhagen Research Center for Mental Health ‐ CORE Mental Health Center Copenhagen Copenhagen University Hospital Copenhagen DenmarkCenter for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) Mental Health Center Glostrup Copenhagen University Hospital Glostrup DenmarkCopenhagen Research Center for Mental Health ‐ CORE Mental Health Center Copenhagen Copenhagen University Hospital Copenhagen DenmarkCopenhagen Research Center for Mental Health ‐ CORE Mental Health Center Copenhagen Copenhagen University Hospital Copenhagen DenmarkCopenhagen Research Center for Mental Health ‐ CORE Mental Health Center Copenhagen Copenhagen University Hospital Copenhagen DenmarkCenter for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) Mental Health Center Glostrup Copenhagen University Hospital Glostrup DenmarkCopenhagen Research Center for Mental Health ‐ CORE Mental Health Center Copenhagen Copenhagen University Hospital Copenhagen DenmarkAbstract Objective Widespread neurocognitive impairment is well‐established in individuals at ultra‐high risk (UHR) for developing psychoses, but it is unknown whether slowed processing speed may underlie impairment in other neurocognitive domains, as found in schizophrenia. The study delineated domain functioning in a UHR sample and examined if neurocognitive slowing might account for deficits across domains. Methods The cross‐sectional study included 50 UHR individuals with no (n = 38) or minimal antipsychotic exposure (n = 12; mean lifetime dose of haloperidol equivalent = 17.56 mg; SD = 13.04) and 50 matched healthy controls. Primary analyses compared group performance across neurocognitive domains before and after covarying for processing speed. To examine the specificity of processing speed effects, post hoc analyses examined the impact of the other neurocognitive domains and intelligence as covariates. Results UHR individuals exhibited significant impairment across all neurocognitive domains (all ps ≤ .010), with medium to large effect sizes (Cohen's ds = −0.53 to −1.12). Only processing speed used as covariate eliminated significant between‐group differences in all other domains, reducing unadjusted Cohen's d values with 68% on average, whereas the other domains used as covariates averagely reduced unadjusted Cohen's d values with 20% to 48%. When covarying each of the other domains after their shared variance with speed of processing was removed, all significant between‐group domain differences remained (all ps ≤ .024). Conclusion Slowed processing speed may underlie generalized neurocognitive impairment in UHR individuals and represent a potential intervention target.https://doi.org/10.1002/brb3.1962at‐risk mental stateclinical high riskcognitionneuropsychologyschizophrenia
spellingShingle Lasse Randers
Jens Richardt Møllegaard Jepsen
Birgitte Fagerlund
Dorte Nordholm
Kristine Krakauer
Carsten Hjorthøj
Birte Glenthøj
Merete Nordentoft
Generalized neurocognitive impairment in individuals at ultra‐high risk for psychosis: The possible key role of slowed processing speed
Brain and Behavior
at‐risk mental state
clinical high risk
cognition
neuropsychology
schizophrenia
title Generalized neurocognitive impairment in individuals at ultra‐high risk for psychosis: The possible key role of slowed processing speed
title_full Generalized neurocognitive impairment in individuals at ultra‐high risk for psychosis: The possible key role of slowed processing speed
title_fullStr Generalized neurocognitive impairment in individuals at ultra‐high risk for psychosis: The possible key role of slowed processing speed
title_full_unstemmed Generalized neurocognitive impairment in individuals at ultra‐high risk for psychosis: The possible key role of slowed processing speed
title_short Generalized neurocognitive impairment in individuals at ultra‐high risk for psychosis: The possible key role of slowed processing speed
title_sort generalized neurocognitive impairment in individuals at ultra high risk for psychosis the possible key role of slowed processing speed
topic at‐risk mental state
clinical high risk
cognition
neuropsychology
schizophrenia
url https://doi.org/10.1002/brb3.1962
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