Lundsgaard Julie, Kristensen Tina Dam, Wenneberg Christina, Gregersen Maja, Nordentoft Merete, Glenthøj Louise Birkedal
Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark.
Centre for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.
Schizophrenia (Heidelb). 2022 Oct 7;8(1):79. doi: 10.1038/s41537-022-00285-1.
Premorbid social and academic adjustment are important predictors of cognitive and functional performance in schizophrenia. Whether this relationship is also present in individuals at ultra-high risk (UHR) for psychosis is the focus of the present study. Using baseline data from a randomised clinical trial (N = 146) this study investigated associations between premorbid adjustment and neuro- and social cognition and functioning in UHR individuals aged 18-40 years. Patients were evaluated with the Premorbid Adjustment Scale (PAS) comprising a social and an academic domain. Using validated measures neurocognition was assessed in the domains of processing speed, executive function, attention, verbal learning and memory, visual learning and memory, and working memory along with estimated IQ. Social cognitive domains assessed were theory of mind, emotion recognition, and attributional bias. Functional assessment comprised the domains of social- and role functioning, functional capacity, and quality of life. Linear regression analyses revealed poor premorbid academic adjustment to be associated with poorer performance in processing speed, working memory, attention, full scale IQ, and verbal IQ. Poor premorbid social adjustment was associated with theory of mind deficits. Additionally, both premorbid adjustment domains were associated with social- and role functioning and quality of life. Corroborating evidence from schizophrenia samples, our findings indicate poor premorbid adjustment to correlate with deficits in specific cognitive and functional domains in UHR states. Early premorbid adjustment difficulties may therefore indicate a poor cognitive and functional trajectory associated with significant impairments in early and established psychotic disorders suggesting targets for primary intervention.
病前的社会和学业适应是精神分裂症认知和功能表现的重要预测指标。这种关系在超高风险（UHR）精神病个体中是否也存在是本研究的重点。本研究使用一项随机临床试验（N = 146）的基线数据，调查了18至40岁UHR个体病前适应与神经认知、社会认知及功能之间的关联。患者使用病前适应量表（PAS）进行评估，该量表包括社会和学业领域。使用经过验证的测量方法，在处理速度、执行功能、注意力、言语学习和记忆、视觉学习和记忆以及工作记忆等领域以及估计智商方面评估神经认知。评估的社会认知领域包括心理理论、情绪识别和归因偏差。功能评估包括社会和角色功能、功能能力和生活质量等领域。线性回归分析显示，病前学业适应不良与处理速度、工作记忆、注意力、全量表智商和言语智商较差有关。病前社会适应不良与心理理论缺陷有关。此外，两个病前适应领域都与社会和角色功能以及生活质量有关。与精神分裂症样本的证据一致，我们的研究结果表明，病前适应不良与UHR状态下特定认知和功能领域的缺陷相关。因此，早期病前适应困难可能表明与早期和已确诊的精神障碍中的显著损害相关的认知和功能轨迹较差，这提示了初级干预的目标。
