“Cognitive Functioning throughout Adulthood and Illness Stages in Individuals With Psychotic Disorders and Their Unaffected Siblings”, Eva Velthorst, Josephine Mollon, Robin M. Murray, Lieuwe Haan, Inez Myin Germeys, David C. Glahn, Celso Arango, Els Ven, Marta Forti, Miguel Bernardo, Sinan Guloksuz, Philippe Delespaul, Gisela Mezquida, Silvia Amoretti, Julio Bobes, Pilar A. Saiz, María Paz García-Portilla, José Luis Santos, Estela Jiménez-López, Julio Sanjuan, Eduardo J. Aguilar, Manuel Arrojo, Angel Carracedo, Gonzalo López, Javier González-Peñas, Mara Parellada, Cem Atbaşoğlu, Meram Can Saka, Alp Üçok, Köksal Alptekin, Berna Akdede, Tolga Binbay, Vesile Altınyazar, Halis Ulaş, Berna Yalınçetin, Güvem Gümüş-Akay, Burçin Cihan Beyaz, Haldun Soygür, Eylem Şahin Cankurtaran, Semra Ulusoy Kaymak, Nadja P. Maric, Marina M. Mihaljevic, Sanja Andric Petrovic, Tijana Mirjanic, Cristina Marta Del-Ben, Laura Ferraro, Charlotte Gayer-Anderson, Peter B. Jones, Hannah E. Jongsma, James B. Kirkbride, Caterina Cascia, Antonio Lasalvia, Sarah Tosato, Pierre-Michel Llorca, Paulo Rossi Menezes, Craig Morgan, Diego Quattrone, Marco Menchetti, Jean-Paul Selten, Andrei Szöke, Ilaria Tarricone, Andrea Tortelli, Philip McGuire, Lucia Valmaggia, Matthew J. Kempton, Mark Gaag, Anita Riecher-Rössler, Rodrigo A. Bressan, Neus Barrantes-Vidal, Barnaby Nelson, Patrick McGorry, Chris Pantelis, Marie-Odile Krebs, Stephan Ruhrmann, Gabriele Sachs, Bart P. F. Rutten, Jim Os, Behrooz Z. Alizadeh, Therese Amelsvoort, Agna A. Bartels-Velthuis, Richard Bruggeman, Nico J. Beveren, Jurjen J. Luykx, Wiepke Cahn, Claudia J. P. Simons, Rene S. Kahn, Frederike Schirmbeck, Ruud Winkel, Maria Calem, Stefania Tognin, Gemma Modinos, Sara Pisani, Tamar C. Kraan, Daniella S. van Dam, Nadine Burger, G. Paul Amminger, Athena Politis, Joanne Goodall, Stefan Borgwardt, Erich Studerus, Ary Gadelha, Elisa Brietzke, Graccielle Asevedo, Elson Asevedo, Andre Zugman, Tecelli Domínguez-Martínez, Manel Monsonet, Paula Cristóbal-Narváez, Anna Racioppi, Thomas R. Kwapil, Mathilde Kazes, Claire Daban, Julie Bourgin, Olivier Gay, Célia Mam-Lam-Fook, Dorte Nordholm, Lasse Rander, Kristine Krakauer, Louise Birkedal Glenthøj, Birte Glenthøj, Dominika Gebhard, Julia Arnhold, Joachim Klosterkötter, Iris Lasser, Bernadette Winklbaur, Abraham Reichenberg2021-01-07 (IQ; similar):
Important questions remain about the profile of cognitive impairment in psychotic disorders across adulthood and illness stages. The age-associated profile of familial impairments also remains unclear, as well as the effect of factors, such as symptoms, functioning, and medication.
Using cross-sectional data from the EU-GEI and GROUP studies, comprising 8455 participants aged 18 to 65, we examined cognitive functioning across adulthood in patients with psychotic disorders (n = 2883), and their unaffected siblings (n = 2271), compared to controls (n = 3301). An abbreviated WAIS-III measured verbal knowledge, working memory, visuospatial processing, processing speed, and IQ.
Patients showed medium to large deficits across all functions (ES range = −0.45 to −0.73, p < 0.001), while siblings showed small deficits on IQ, verbal knowledge, and working memory (ES = −0.14 to −0.33, p < 0.001). Magnitude of impairment was not associated with participant age, such that the size of impairment in older and younger patients did not statistically-significantly differ. However, first-episode patients performed worse than prodromal patients (ES range = −0.88 to −0.60, p < 0.001). Adjusting for cannabis use, symptom severity, and global functioning attenuated impairments in siblings, while deficits in patients remained statistically-significant, albeit reduced by half (ES range = −0.13 to −0.38, p < 0.01). Antipsychotic medication also accounted for around half of the impairment in patients (ES range = −0.21 to −0.43, p < 0.01).
Deficits in verbal knowledge, and working memory may specifically index familial, ie. shared genetic and/or shared environmental, liability for psychotic disorders. Nevertheless, potentially modifiable illness-related factors account for a substantial portion of the cognitive impairment in psychotic disorders.