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. 2023 Oct;53(13):5945-5957.
doi: 10.1017/S0033291723001770. Epub 2023 Jul 6.

Prevalence of cognitive impairments and strengths in the early course of psychosis and depression

Alexandra Stainton  1   2 , Katharine Chisholm  3 , Siân Lowri Griffiths  4 , Lana Kambeitz-Ilankovic  5   6 , Julian Wenzel  5 , Carolina Bonivento  7 , Paolo Brambilla  8   9 , Mariam Iqbal  10 , Theresa K Lichtenstein  5 , Marlene Rosen  5 , Linda A Antonucci  11 , Eleonora Maggioni  12 , Joseph Kambeitz  5 , Stefan Borgwardt  13   14 , Anita Riecher-Rössler  15 , Christina Andreou  14 , André Schmidt  14 , Frauke Schultze-Lutter  16   17   18 , Eva Meisenzahl  16 , Stephan Ruhrmann  5 , Raimo K R Salokangas  19 , Christos Pantelis  20 , Rebekka Lencer  13   21 , Georg Romer  22 , Alessandro Bertolino  11 , Rachel Upthegrove  4   23 , Nikolaos Koutsouleris  24   25   26 , Kelly Allott  1   2 , Stephen J Wood  1   2   27 ; PRONIA Consortium; PRONIA Consortium
Collaborators, Affiliations

Prevalence of cognitive impairments and strengths in the early course of psychosis and depression

Alexandra Stainton et al. Psychol Med. 2023 Oct.

Abstract

Background: Studies investigating cognitive impairments in psychosis and depression have typically compared the average performance of the clinical group against healthy controls (HC), and do not report on the actual prevalence of cognitive impairments or strengths within these clinical groups. This information is essential so that clinical services can provide adequate resources to supporting cognitive functioning. Thus, we investigated this prevalence in individuals in the early course of psychosis or depression.

Methods: A comprehensive cognitive test battery comprising 12 tests was completed by 1286 individuals aged 15-41 (mean age 25.07, s.d. 5.88) from the PRONIA study at baseline: HC (N = 454), clinical high risk for psychosis (CHR; N = 270), recent-onset depression (ROD; N = 267), and recent-onset psychosis (ROP; N = 295). Z-scores were calculated to estimate the prevalence of moderate or severe deficits or strengths (>2 s.d. or 1-2 s.d. below or above HC, respectively) for each cognitive test.

Results: Impairment in at least two cognitive tests was as follows: ROP (88.3% moderately, 45.1% severely impaired), CHR (71.2% moderately, 22.4% severely impaired), ROD (61.6% moderately, 16.2% severely impaired). Across clinical groups, impairments were most prevalent in tests of working memory, processing speed, and verbal learning. Above average performance (>1 s.d.) in at least two tests was present for 40.5% ROD, 36.1% CHR, 16.1% ROP, and was >2 SDs in 1.8% ROD, 1.4% CHR, and 0% ROP.

Conclusions: These findings suggest that interventions should be tailored to the individual, with working memory, processing speed, and verbal learning likely to be important transdiagnostic targets.

Keywords: Mental health; processing speed; psychosis; verbal learning; working memory.

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Figures

Figure 1.
Figure 1.
Prevalence of impairments (a); >1 s.d. below average and strengths (b); >1 s.d. above average per group in the individual cognitive tests. Note: Sample sizes provided are of the whole sample. Individual sample sizes for each test can be found in Table 2. Tests are presented in order from highest to lowest prevalence in the ROP group.
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