Please use this identifier to cite or link to this item: https://doi.org/10.1001/jamapsychiatry.2018.1668
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dc.titleLongitudinal cognitive changes in young individuals at ultrahigh risk for psychosis
dc.contributor.authorLam, M
dc.contributor.authorLee, J
dc.contributor.authorRapisarda, A
dc.contributor.authorSee, Y.M
dc.contributor.authorYang, Z
dc.contributor.authorLee, S.-A
dc.contributor.authorAbdul-Rashid, N.A
dc.contributor.authorKraus, M
dc.contributor.authorSubramaniam, M
dc.contributor.authorChong, S.-A
dc.contributor.authorKeefe, R.S.E
dc.date.accessioned2020-11-23T08:46:45Z
dc.date.available2020-11-23T08:46:45Z
dc.date.issued2018
dc.identifier.citationLam, M, Lee, J, Rapisarda, A, See, Y.M, Yang, Z, Lee, S.-A, Abdul-Rashid, N.A, Kraus, M, Subramaniam, M, Chong, S.-A, Keefe, R.S.E (2018). Longitudinal cognitive changes in young individuals at ultrahigh risk for psychosis. JAMA Psychiatry 75 (9) : 929-939. ScholarBank@NUS Repository. https://doi.org/10.1001/jamapsychiatry.2018.1668
dc.identifier.issn2168-622X
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/183833
dc.description.abstractImportance: Cognitive deficits are a key feature of risk for psychosis. Longitudinal changes in cognitive architecture may be associated with the social and occupational functioning in young people. Objectives: To examine longitudinal profiles of cognition in individuals at ultrahigh risk (UHR) for psychosis, compared with healthy controls, and to investigate the association of cognition with functioning. Design, Setting, and Participants: This study has a multiple-group prospective design completed in 24 months and was conducted from January 1, 2009, to November 11, 2012, as part of the Longitudinal Youth at-Risk Study conducted in Singapore. Participants either were recruited from psychiatric outpatient clinics, educational institutions, and community mental health agencies or self-referred. Follow-up assessments were performed every 6 months for 2 years or until conversion to psychosis. Individuals with medical causes for psychosis, current illicit substance use, or color blindness were excluded. Data analysis was conducted from June 2014 to May 2018. Main Outcomes and Measures: Neuropsychological, perceptual, and social cognitive tasks; semi-structured interviews, and the Structured Clinical Interview for DSM-IV Axis I disorders were administered every 6 months. The UHR status of nonconverters, converters, remitters, and nonremitters was monitored. Cognitive domain scores and functioning were investigated longitudinally. Results: In total, 384 healthy controls and 173 UHR individuals between ages 14 and 29 years were evaluated prospectively. Of the 384 healthy controls, 153 (39.8%) were female and 231 (60.2%) were male with a mean (SD) age of 21.69 (3.26) years. Of the 173 individuals at UHR for psychosis, 56 (32.4%) were female and 117 (67.6%) were male with a mean (SD) age of 21.27 (3.52) years). After 24 months of follow-up, 383 healthy controls (99.7%) and 122 individuals at UHR for psychosis (70.5%) remained. Baseline cognitive deficits were associated with psychosis conversion later (mean odds ratio [OR], 1.66; combined 95%CI, 1.08-2.83; P = .04) and nonremission of UHR status (mean OR, 1.67; combined 95%CI, 1.09-2.95; P = .04). Five cognitive components-social cognition, attention, verbal fluency, general cognitive function, and perception-were obtained from principal components analysis. Longitudinal component structure change was observed in general cognitive function (maximum vertical deviation = 0.59; ?2 = 8.03; P = .01). Group-by-time interaction on general cognitive function (F = 12.23; ?2 = 0.047; P < .001) and perception (F = 8.33; ?2 = 0.032; P < .001) was present. Changes in attention (F = 5.65; ?2 = 0.013; P = .02) and general cognitive function (F = 7.18; ?2 = 0.014; P = .01) accounted for longitudinal changes in social and occupational functioning. Conclusions and Relevance: Individuals in this study who met the UHR criteria appeared to demonstrate cognitive deficits, and those whose UHR status remitted were seen to recover cognitively. Cognition appeared as poor in nonremitters and appeared to be associated with poor functional outcome. This study suggests that cognitive dimensions are sensitive to the identification of young individuals at risk for psychosis and to the longitudinal course of those at highest risk. © 2018 American Medical Association. All rights reserved.
dc.publisherAmerican Medical Association
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceUnpaywall 20201031
dc.subjectadolescent
dc.subjectadult
dc.subjectArticle
dc.subjectattention
dc.subjectBeck Anxiety Inventory
dc.subjectCalgary Depression Scale
dc.subjectclinical evaluation
dc.subjectcognition
dc.subjectcognitive defect
dc.subjectcolor blindness
dc.subjectcommunity mental health
dc.subjectcontrolled study
dc.subjectDSM-IV
dc.subjectfemale
dc.subjectfollow up
dc.subjecthigh risk population
dc.subjecthuman
dc.subjectlongitudinal study
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectodds ratio
dc.subjectoutpatient department
dc.subjectperception
dc.subjectPositive and Negative Syndrome Scale
dc.subjectprincipal component analysis
dc.subjectprospective study
dc.subjectpsychosis
dc.subjectrisk assessment
dc.subjectschool
dc.subjectsemi structured interview
dc.subjectSingapore
dc.subjectSocial and Occupational Functioning Assessment Scale
dc.subjectsocial cognition
dc.subjectStructured Clinical Interview for DSM Disorders
dc.subjectsubstance use
dc.subjectverbal memory
dc.subjectyoung adult
dc.subjectcognitive defect
dc.subjectDiagnostic and Statistical Manual of Mental Disorders
dc.subjectmental disease
dc.subjectneuropsychological test
dc.subjectprocedures
dc.subjectpsychological interview
dc.subjectpsychological rating scale
dc.subjectpsychology
dc.subjectpsychosis
dc.subjectrisk assessment
dc.subjectrisk factor
dc.subjectsocial behavior
dc.subjectAdolescent
dc.subjectCognition
dc.subjectCognitive Dysfunction
dc.subjectDiagnostic and Statistical Manual of Mental Disorders
dc.subjectFemale
dc.subjectHumans
dc.subjectInterview, Psychological
dc.subjectLongitudinal Studies
dc.subjectMale
dc.subjectNeuropsychological Tests
dc.subjectPsychiatric Status Rating Scales
dc.subjectPsychopathology
dc.subjectPsychotic Disorders
dc.subjectRisk Assessment
dc.subjectRisk Factors
dc.subjectSingapore
dc.subjectSocial Behavior
dc.subjectYoung Adult
dc.typeArticle
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.description.doi10.1001/jamapsychiatry.2018.1668
dc.description.sourcetitleJAMA Psychiatry
dc.description.volume75
dc.description.issue9
dc.description.page929-939
dc.published.statepublished
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