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)

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: Uhlhaas, Professor Peter and Gross, Professor Joachim and Gumley, Professor Andrew and Gajwani, Dr Ruchika and Haining, Dr Kate and Ince, Dr Robin
• 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 > School of Health & 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

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
190713		Using Magnetoencephalography to Investigate Aberrant Neural Synchrony in Prodromal Schizophrenia: A Translational Biomarker Approach	Peter Uhlhaas	Medical Research Council (MRC)	MR/L011689/1	NP - Centre for Cognitive Neuroimaging (CCNi)