The relationship of symptom dimensions with premorbid adjustment and cognitive characteristics at first episode psychosis: Findings from the EU-GEI study
Ferraro, Laura; La Cascia, Caterina; La Barbera, Daniele; Sanchez-Gutierrez, Teresa; Tripoli, Giada; Seminerio, Fabio; Sartorio, Crocettarachele; Marrazzo, Giovanna; Sideli, Lucia; Arango, Celso; Arrojo, Manuel; Bernardo, Miguel; Bobes, Julio; Del-Ben, Cristina Marta; Gayer-Anderson, Charlotte; Jongsma, Hannah E.; Kirkbride, James B.; Lasalvia, Antonio; Tosato, Sarah; Llorca, Pierre Michel; Menezes, Paulo Rossi; Rutten, Bart P.; Santos, Jose Luis; Sanjuán, Julio; Selten, Jean Paul; Szöke, Andrei; Tarricone, Ilaria; Muratori, Roberto; Tortelli, Andrea; Velthorst, Eva; Rodriguez, Victoria; Quattrone, Andrea; Jones, Peter B.; Van Os, Jim; Vassos, Evangelos; Morgan, Craig; de Haan, Lieuwe; Reininghaus, Ulrich; Cardno, Alastair G.; Di Forti, Marta; Murray, Robin M.; Quattrone, Diego
(2021) Schizophrenia Research, volume 236, pp. 69 - 79
(Article)
Abstract
Premorbid functioning and cognitive measures may reflect gradients of developmental impairment across diagnostic categories in psychosis. In this study, we sought to examine the associations of current cognition and premorbid adjustment with symptom dimensions in a large first episode psychosis (FEP) sample. We used data from the international EU-GEI study.
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Bifactor modelling of the Operational Criteria in Studies of Psychotic Illness (OPCRIT) ratings provided general and specific symptom dimension scores. Premorbid Adjustment Scale estimated premorbid social (PSF) and academic adjustment (PAF), and WAIS-brief version measured IQ. A MANCOVA model examined the relationship between symptom dimensions and PSF, PAF, and IQ, having age, sex, country, self-ascribed ethnicity and frequency of cannabis use as confounders. In 785 patients, better PSF was associated with fewer negative (B = −0.12, 95% C.I. −0.18, −0.06, p < 0.001) and depressive (B = −0.09, 95% C.I. −0.15, −0.03, p = 0.032), and more manic (B = 0.07, 95% C.I. 0.01, 0.14, p = 0.023) symptoms. Patients with a lower IQ presented with slightly more negative and positive, and fewer manic, symptoms. Secondary analysis on IQ subdomains revealed associations between better perceptual reasoning and fewer negative (B = −0.09, 95% C.I. −0.17, −0.01, p = 0.023) and more manic (B = 0.10, 95% C.I. 0.02, 0.18, p = 0.014) symptoms. Fewer positive symptoms were associated with better processing speed (B = −0.12, 95% C.I. −0.02, −0.004, p = 0.003) and working memory (B = −0.10, 95% C.I. −0.18, −0.01, p = 0.024). These findings suggest that the negative and manic symptom dimensions may serve as clinical proxies of different neurodevelopmental predisposition in psychosis.
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Keywords: Cognitive domains, First episode psychosis, IQ, Premorbid adjustment, Symptom dimensions, Transdiagnostic, Psychiatry and Mental health, Biological Psychiatry
ISSN: 0920-9964
Publisher: Elsevier
Note: Funding Information: The EU-GEI Study is funded by grant agreement HEALTH-F2-2010-241909 (Project EU-GEI) from the European Community's Seventh Framework Programme , and Grant 2012/0417-0 from the São Paulo Research Foundation . DQ's research was supported by a Guarantors of Brain post-doctoral clinical fellowship. The work was further funded by: Clinician Scientist Medical Research Council fellowship (project reference MR/M008436/1 ) to MDF. Funding Information: The EU-GEI Study is funded by grant agreement HEALTH-F2-2010-241909 (Project EU-GEI) from the European Community's Seventh Framework Programme, and Grant 2012/0417-0 from the S?o Paulo Research Foundation. DQ's research was supported by a Guarantors of Brain post-doctoral clinical fellowship. The work was further funded by: Clinician Scientist Medical Research Council fellowship (project reference MR/M008436/1) to MDF. The European Network of National Schizophrenia Networks Studying Gene?Environment Interactions (EU-GEI) WP2 Group non-author members include: (Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK), Stephanie Beards (Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK), Simona A. Stilo (Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK), Mara Parellada (Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Mara??n, School of Medicine, Universidad Complutense, Investigaci?n Sanitaria del Hospital Gregorio Mara??n (IiSGM), Centro de Investigaci?n Biom?dica en Red de Salud Mental (CIBERSAM), Madrid, Spain), Pedro Cuadrado (Villa de Vallecas Mental Health Department, Villa de Vallecas Mental Health Centre, Hospital Universitario Infanta Leonor/Hospital Virgen de la Torre, Madrid, Spain), Jos? Juan Rodr?guez Solano (Puente de Vallecas Mental Health Department, Hospital Universitario Infanta Leonor/Hospital Virgen de la Torre, Centro de Salud Mental Puente de Vallecas, C/Pe?a Gorbea 4, 28018 Madrid, Spain), Angel Carracedo (Fundaci?n P?blica Galega de Medicina Xen?mica, Hospital Cl?nico Universitario, Choupana s/n, 15782 Santiago de Compostela, Spain), David Fraguas MD, PhD, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Mara??n, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain), ?lvaro Andreu-Bernabeu MD, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Mara??n, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain), Gonzalo L?pez (Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Mara??n, School of Medicine, Universidad Complutense, Investigaci?n Sanitaria del Hospital Gregorio Mara??n (IiSGM), Centro de Investigaci?n Biom?dica en Red de Salud Mental (CIBERSAM), Madrid, Spain), Bibiana Cabrera (Department of Psychiatry, Hospital Clinic, Institut d'Investigacions Biom?diques August Pi i Sunyer (IDIBAPS), Centro de Investigaci?n Biom?dica en Red de Salud Mental (CIBERSAM), Universidad de Barcelona, C/Villarroel 170, escalera 9, planta 6, 08036 Barcelona, Spain), Esther Lorente-Rovira (Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigaci?n Biom?dica en Red de Salud Mental (CIBERSAM), C/Avda. Blasco Ib??ez 15, 46010 Valencia, Spain), Paz Garcia-Portilla (Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigaci?n Biom?dica en Red de Salud Mental (CIBERSAM), C/Juli?n Claver?a s/n, 33006 Oviedo, Spain), Javier Costas (Fundaci?n P?blica Galega de Medicina Xen?mica, Hospital Cl?nico Universitario, Choupana s/n, 15782 Santiago de Compostela, Spain), Estela Jim?nez-L?pez (Department of Psychiatry, Servicio de Psiquiatr?a Hospital ?Virgen de la Luz?, C/ Hermandad de Donantes de Sangre, 16002 Cuenca, Spain), Mario Matteis (Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Mara??n, School of Medicine, Universidad Complutense, Investigaci?n Sanitaria del Hospital Gregorio Mara??n (IiSGM), Centro de Investigaci?n Biom?dica en Red de Salud Mental (CIBERSAM), Madrid, Spain), Marta Rapado-Castro (Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Mara.n, School of Medicine, Universidad Complutense, Investigaci.n Sanitaria del Hospital Gregorio Mara.n (IiSGM), Centro de Investigaci.n Biom.dica en Red de Salud Mental (CIBERSAM), Madrid, Spain), Emiliano Gonz?lez (Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Mara??n, School of Medicine, Universidad Complutense, Investigaci?n Sanitaria del Hospital Gregorio Mara??n (IiSGM), Centro de Investigaci?n Biom?dica en Red de Salud Mental (CIBERSAM), Madrid, Spain), Covadonga M. D?az-Caneja (MD, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Mara??n, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain), Emilio S?nchez (Department of Psychiatry, Hospital General Universitario Gregorio Mara??n, School of Medicine, Universidad Complutense, Investigaci?n Sanitaria del Hospital Gregorio Mara??n (IiSGM), Centro de Investigaci?n Biom?dica en Red de Salud Mental (CIBERSAM), C/Doctor Esquerdo 46, 28007 Madrid, Spain), Manuel Dur?n-Cutilla (MD, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Mara??n, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain), Nathalie Franke (Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands), Fabian Termorshuizen (Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands, Rivierduinen Centre for Mental Health, Leiden, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands), Daniella van Dam (Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands), Elsje van der Ven (Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands, Rivierduinen Centre for Mental Health, Leiden, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands), Elles Messchaart (Rivierduinen Centre for Mental Health, Leiden, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands), Marion Leboyer (AP-HP, Groupe Hospitalier ?Mondor?, P?le de Psychiatrie, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France, Institut National de la Sant? et de la Recherche M?dicale (INSERM), U955, Equipe 15, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France, Facult? de M?decine, Universit? Paris-Est, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France, Fondation Fondamental, 40 Rue de Mesly, 94000 Cr?teil, France), Franck Sch?rhoff (AP-HP, Groupe Hospitalier ?Mondor?, P?le de Psychiatrie, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France, Institut National de la Sant? et de la Recherche M?dicale (INSERM), U955, Equipe 15, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France, Facult? de M?decine, Universit? Paris-Est, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France, Fondation Fondamental, 40 Rue de Mesly, 94000 Cr?teil, France), St?phane Jamain (Institut National de la Sant? et de la Recherche M?dicale (INSERM), U955, Equipe 15, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France, Facult? de M?decine, Universit? Paris-Est, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France, Fondation Fondamental, 40 Rue de Mesly, 94000 Cr?teil, France), Jean-Romain Richard (Institut National de la Sant? et de la Recherche M?dicale (INSERM), U955, Equipe 15, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France, Fondation Fondamental, 40 Rue de Mesly, 94000 Cr?teil, France), Gr?goire Baudin (AP-HP, Groupe Hospitalier ?Mondor?, P?le de Psychiatrie, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France, Institut National de la Sant? et de la Recherche M?dicale (INSERM), U955, Equipe 15, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France), Aziz Ferchiou (AP-HP, Groupe Hospitalier ?Mondor?, P?le de Psychiatrie, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France, Institut National de la Sant? et de la Recherche M?dicale (INSERM), U955, Equipe 15, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France), Baptiste Pignon (AP-HP, Groupe Hospitalier ?Mondor?, P?le de Psychiatrie, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France, Institut National de la Sant? et de la Recherche M?dicale (INSERM), U955, Equipe 15, 51 Avenue de Mar?chal de Lattre de Tassigny, 94010 Cr?teil, France, Fondation Fondamental, 40 Rue de Mesly, 94000 Cr?teil, France), Thomas Charpeaud (Fondation Fondamental, 40 Rue de Mesly, 94000 Cr?teil, France, CMP B CHU, BP 69, 63003 Clermont Ferrand, Cedex 1, France, Universit? Clermont Auvergne, EA 7280, Clermont-Ferrand 63000, France), Anne-Marie Tronche(Fondation Fondamental, 40 Rue de Mesly, 94000 Cr?teil, France, CMP B CHU, BP 69, 63003 Clermont Ferrand, Cedex 1, France, Universit? Clermont Auvergne, EA 7280, Clermont-Ferrand 63000, France), Flora Frijda (Etablissement Public de Sant? (EPS), Maison Blanche, Paris 75020, France), Marcelino Loureiro (Departamento de Neuroci?ncias e Ciencias do Comportamento, Faculdade de Medicina de Ribeir?o Preto, Universidade de S?o Paulo, Av. Bandeirantes, 3900-Monte Alegre- CEP 14049- 900, Ribeir?o Preto, SP, Brasil, N?cleo de Pesquina em Sa?de Mental Populacional, Universidade de S?o Paulo, Avenida Doutor Arnaldo 455, CEP 01246-903, SP, Brasil), Rosana Shuhama (Departamento de Neuroci?ncias e Ciencias do Comportamento, Faculdade de Medicina de Ribeir?o Preto, Universidade de S?o Paulo, Av. Bandeirantes, 3900- Monte Alegre- CEP 14049-900, Ribeir?o Preto, SP, Brasil, N?cleo de Pesquina em Sa?de Mental Populacional, Universidade de S?o Paulo, Avenida Doutor Arnaldo 455, CEP 01246-903, SP, Brasil), Mirella Ruggeri (Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy), Chiara Bonetto (Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy), Doriana Cristofalo (Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy). Domenico Berardi (Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorium Universit? di Bologna, Bologna, Italy), Marco Seri (Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Universit? di Bologna, Viale Pepoli 5, 40126 Bologna, Italy), Elena Bonora (PhD, Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Universit? di Bologna, Viale Pepoli 5, 40126 Bologna, Italy), Giuseppe D'Andrea (MD, Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Universit? di Bologna, Viale Pepoli 5, 40126 Bologna, Italy), Silvia Amoretti (PhD Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain, CIBERSAM, Spain), Gisela Mezquida (PhD, Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain; Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain). Publisher Copyright: © 2021
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