Neurocognitive skills and vulnerability for psychosis in depression and across the psychotic spectrum: findings from the PRONIA Consortium

Carolina Bonivento¹, Lana Kambeitz-Ilankovic², Eleonora Maggioni³, Stefan Borgwardt⁴, Rebekka Lencer⁵, Eva Meisenzahl⁶, Joseph Kambeitz⁷, Stephan Ruhrmann⁸, Raimo K R Salokangas⁹, Alessandro Bertolino¹⁰, Alexandra Stainton¹¹, Julian Wenzel⁸, Christos Pantelis¹², Stephen J Wood¹³, Rachel Upthegrove¹⁴, Nikolaos Koutsouleris¹⁵, Paolo Brambilla¹⁶; PRONIA Consortium

Affiliations

¹ Scientific Institute, IRCCS E. Medea, Pasian di Prato, Udine, Italy.
² Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany; and Faculty of Psychology and Educational Sciences, Department of Psychology, Ludwig-Maximilian University, Germany.
³ Department of Electronics, Information and Bioengineering, Politecnico di Milano, Italy.
⁴ Translational Psychiatry Unit, Department of Psychiatry and Psychotherapy, University of Lübeck, Germany.
⁵ Institute for Translational Psychiatry, Münster University, Germany.
⁶ Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Germany.
⁷ Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany; and Cognitive Neuroscience (INM-3), Institute of Neuroscience and Medicine, Research Center Jülich, Germany.
⁸ Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany.
⁹ Department of Psychiatry, University of Turku, Finland.
¹⁰ Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Italy.
¹¹ Orygen, Melbourne, Australia; and Centre for Youth Mental Health, University of Melbourne, Australia.
¹² Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Australia.
¹³ Orygen, Melbourne, Australia; School of Psychology, University of Birmingham, UK; and Centre for Youth Mental Health, University of Melbourne, Australia.
¹⁴ School of Psychology, University of Birmingham, UK; Institute for Mental Health, University of Birmingham, UK; and Centre for Human Brain Health, University of Birmingham, UK.
¹⁵ Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Germany; Max Planck Institute for Psychiatry, Germany; and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
¹⁶ Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy; and Department of Pathophysiology and Transplantation, University of Milan, Italy.

PMID: 37846967
DOI: 10.1192/bjp.2023.98

Neurocognitive skills and vulnerability for psychosis in depression and across the psychotic spectrum: findings from the PRONIA Consortium

Carolina Bonivento et al. Br J Psychiatry. 2023 Oct.

. 2023 Oct;223(4):485-492.

doi: 10.1192/bjp.2023.98. Epub 2023 Oct 17.

Authors

Affiliations

¹ Scientific Institute, IRCCS E. Medea, Pasian di Prato, Udine, Italy.
² Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany; and Faculty of Psychology and Educational Sciences, Department of Psychology, Ludwig-Maximilian University, Germany.
³ Department of Electronics, Information and Bioengineering, Politecnico di Milano, Italy.
⁴ Translational Psychiatry Unit, Department of Psychiatry and Psychotherapy, University of Lübeck, Germany.
⁵ Institute for Translational Psychiatry, Münster University, Germany.
⁶ Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Germany.
⁷ Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany; and Cognitive Neuroscience (INM-3), Institute of Neuroscience and Medicine, Research Center Jülich, Germany.
⁸ Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany.
⁹ Department of Psychiatry, University of Turku, Finland.
¹⁰ Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Italy.
¹¹ Orygen, Melbourne, Australia; and Centre for Youth Mental Health, University of Melbourne, Australia.
¹² Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Australia.
¹³ Orygen, Melbourne, Australia; School of Psychology, University of Birmingham, UK; and Centre for Youth Mental Health, University of Melbourne, Australia.
¹⁴ School of Psychology, University of Birmingham, UK; Institute for Mental Health, University of Birmingham, UK; and Centre for Human Brain Health, University of Birmingham, UK.
¹⁵ Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Germany; Max Planck Institute for Psychiatry, Germany; and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
¹⁶ Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy; and Department of Pathophysiology and Transplantation, University of Milan, Italy.

PMID: 37846967
DOI: 10.1192/bjp.2023.98

Abstract

Background: Neurocognitive deficits are a core feature of psychosis and depression. Despite commonalities in cognitive alterations, it remains unclear if and how the cognitive deficits in patients at clinical high risk for psychosis (CHR) and those with recent-onset psychosis (ROP) are distinct from those seen in recent-onset depression (ROD).

Aims: This study was carried out within the European project 'Personalized Prognostic Tools for Early Psychosis Management', and aimed to characterise the cognitive profiles of patients with psychosis or depression.

Method: We examined cognitive profiles for patients with ROP (n = 105), patients with ROD (n = 123), patients at CHR (n = 116) and healthy controls (n = 372) across seven sites in five European countries. Confirmatory factor analysis identified four cognitive factors independent of gender, education and site: speed of processing, attention and working memory, verbal learning and spatial learning.

Results: Patients with ROP performed worse than healthy controls in all four domains (P < 0.001), whereas performance of patients with ROD was not affected (P > 0.05). Patients at CHR performed worse than healthy controls in speed of processing (P = 0.001) and spatial learning (P = 0.003), but better than patients with ROP across all cognitive domains (all P ≤ 0.01). CHR and ROD groups did not significantly differ in any cognitive domain. These findings were independent of comorbid depressive symptoms, substance consumption and illness duration.

Conclusions: These results show that neurocognitive abilities are affected in CHR and ROP, whereas ROD seems spared. Although our findings may support the notion that those at CHR have a specific vulnerability to psychosis, future studies investigating broader transdiagnostic risk cohorts in longitudinal designs are needed.

Keywords: Cognitive neuroscience; clinical high risk; recent-onset depression; recent-onset psychosis; risk assessment.

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Neurocognitive skills and vulnerability for psychosis in depression and across the psychotic spectrum: findings from the PRONIA Consortium

Affiliations

Neurocognitive skills and vulnerability for psychosis in depression and across the psychotic spectrum: findings from the PRONIA Consortium

Authors

Affiliations

Abstract

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical