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Neuropsychological evidence for abnormal neurodevelopment associated with early-onset psychoses

Published online by Cambridge University Press:  25 July 2012

I. Bombin*
Affiliation:
Department of Psychology, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain Department of Neuropsychology, Reintegra Foundation, Oviedo, Spain
M. Mayoral
Affiliation:
Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Madrid, Spain
J. Castro-Fornieles
Affiliation:
Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
A. Gonzalez-Pinto
Affiliation:
Stanley Institute International Mood-Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, CIBERSAM, EHU/UPV, Vitoria, Spain
E. de la Serna
Affiliation:
Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
M. Rapado-Castro
Affiliation:
Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Madrid, Spain
S. Barbeito
Affiliation:
Stanley Institute International Mood-Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, CIBERSAM, EHU/UPV, Vitoria, Spain
M. Parellada
Affiliation:
Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Madrid, Spain
I. Baeza
Affiliation:
Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
M. Graell
Affiliation:
Section of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
B. Payá
Affiliation:
Child and Adolescent Mental Health Unit, Department of Psychiatry and Psychology, Hospital Universitario Marqués de Valdecilla, CIBERSAM, Santander, Spain
C. Arango
Affiliation:
Child and Adolescent Psychiatry Department, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, CIBERSAM, Madrid, Spain
*
*Address for correspondence: I. Bombin, Ph.D., Reintegra Foundation: Centro de Rehabilitación Neurológica, C/Eduardo de Fraga Torrejón, 4, bajo, Oviedo 33011, Spain. (Email: ibombin@reintegra-dca.es)

Abstract

Background

The longitudinal neuropsychological study of first-episode early-onset psychosis (EOP) patients, whose brain maturation is still in progress at the time of illness onset, provides a unique opportunity to compare their cognitive development with that of healthy subjects, in search of specific patterns resulting from the interaction between neurodevelopmental processes and the presence of psychotic disorders.

Method

Seventy-five first-episode EOP patients (schizophrenia n = 35; bipolar disorder n = 17; other forms of psychosis n = 23) with a mean age of 15.53 years were assessed with a neuropsychological battery that included measures of attention, working memory, memory and executive functions within 6 months following the onset of the first psychotic symptom (baseline) and 2 years later. Psychotic symptoms were assessed at both times with the Positive and Negative Symptom Scale (PANSS). Seventy-nine healthy subjects matched for age and education served as controls.

Results

EOP patients showed significant cognitive impairment at both baseline and the 2-year follow-up, with no significant differences between diagnostic groups at either time. Both healthy controls and EOP patients improved in all cognitive measures, except for patient working memory. Improvement in patient attention lost significance after controlling for psychotic symptom reduction. No significant time/diagnosis interaction was found among patients (p > 0.405).

Conclusions

Cognitive impairment in EOP is already present at the first episode, and cognitive development seems to be arrested early in EOP patients compared to their healthy peers, at least for some cognitive functions. These and previous similar results support the neurodevelopmental hypothesis of psychosis.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2012

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