Characterising cognitive heterogeneity in individuals at clinical high-risk for psychosis: a cluster analysis with clinical and functional outcome prediction

Haining, K. , Gajwani, R. , Gross, J. , Gumley, A. I. , Ince, R. A.A. , Lawrie, S. M., Schultze-Lutter, F., Schwannauer, M. and Uhlhaas, P. J. (2022) Characterising cognitive heterogeneity in individuals at clinical high-risk for psychosis: a cluster analysis with clinical and functional outcome prediction. European Archives of Psychiatry and Clinical Neuroscience, 272(3), pp. 437-448. (doi: 10.1007/s00406-021-01315-2) (PMID:34401957)

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Abstract

Schizophrenia is characterised by cognitive impairments that are already present during early stages, including in the clinical high-risk for psychosis (CHR-P) state and first-episode psychosis (FEP). Moreover, data suggest the presence of distinct cognitive subtypes during early-stage psychosis, with evidence for spared vs. impaired cognitive profiles that may be differentially associated with symptomatic and functional outcomes. Using cluster analysis, we sought to determine whether cognitive subgroups were associated with clinical and functional outcomes in CHR-P individuals. Data were available for 146 CHR-P participants of whom 122 completed a 6- and/or 12-month follow-up; 15 FEP participants; 47 participants not fulfilling CHR-P criteria (CHR-Ns); and 53 healthy controls (HCs). We performed hierarchical cluster analysis on principal components derived from neurocognitive and social cognitive measures. Within the CHR-P group, clusters were compared on clinical and functional variables and examined for associations with global functioning, persistent attenuated psychotic symptoms and transition to psychosis. Two discrete cognitive subgroups emerged across all participants: 45.9% of CHR-P individuals were cognitively impaired compared to 93.3% of FEP, 29.8% of CHR-N and 30.2% of HC participants. Cognitively impaired CHR-P participants also had significantly poorer functioning at baseline and follow-up than their cognitively spared counterparts. Specifically, cluster membership predicted functional but not clinical outcome. Our findings support the existence of distinct cognitive subgroups in CHR-P individuals that are associated with functional outcomes, with implications for early intervention and the understanding of underlying developmental processes.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gajwani, Dr Ruchika and Uhlhaas, Professor Peter and Ince, Dr Robin and Gross, Professor Joachim and Gumley, Professor Andrew and Haining, Kate
Authors: Haining, K., Gajwani, R., Gross, J., Gumley, A. I., Ince, R. A.A., Lawrie, S. M., Schultze-Lutter, F., Schwannauer, M., and Uhlhaas, P. J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
Journal Name:European Archives of Psychiatry and Clinical Neuroscience
Publisher:Springer
ISSN:0940-1334
ISSN (Online):1433-8491
Published Online:16 August 2021
Copyright Holders:Copyright © 2021 Crown
First Published:First published in European Archives of Psychiatry and Clinical Neuroscience 272(3): 437-448
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
190713Using Magnetoencephalography to Investigate Aberrant Neural Synchrony in Prodromal Schizophrenia: A Translational Biomarker ApproachPeter UhlhaasMedical Research Council (MRC)MR/L011689/1NP - Centre for Cognitive Neuroimaging (CCNi)