作者
Eva Velthorst,Josephine Mollon,Robin M. Murray,Lieuwe de Haan,Inez Myin‐Germeys,David C. Glahn,Celso Arango,Els van der Ven,Marta Di Forti,Miguel Bernardo,Sinan Gülöksüz,Philippe Delespaul,Gisela Mezquida,Sílvia Amoretti,Julio Bobes,Pilar A. Sáiz,María Paz García-Portilla,José Luís Santos,Estela Jiménez‐López,Julio Sanjuán,Eduardo J. Aguilar,Manuel Arrojo,Ángel Carracedo,Gonzalo López,Javier González-Peñas,Mara Parellada,Cem Atbaşoğlu,Meram Can Saka,Alp Üçok,Köksal Alptekın,Berna Binnur 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. Marić,Marina Mihaljević,Sanja Petrović,Tijana Mirjanić,Cristina Marta Del-Ben,Laura Ferraro,Charlotte Gayer‐Anderson,Peter B. Jones,Hannah E Jongsma,James Kirkbride,Caterina La Cascia,Antonio Lasalvia,Sarah Tosato,Pierre‐Michel Llorca,Paulo Rossi Menezes,Craig Morgan,Diego Quattrone,Marco Menchetti,Jean‐Paul Selten,Andreı̈ Szöke,Ilaria Tarricone,Andrea Tortelli,Philip McGuire,Lucia Valmaggia,Matthew J. Kempton,Mark van der Gaag,Anita Riecher-Rössler,Rodrigo Bressan,Neus Barrantes‐Vidal,Barnaby Nelson,Patrick D. McGorry,C. Pantelis,Marie‐Odile Krebs,Stephan Ruhrmann,Gabriele Sachs,Bart P. F. Rutten,Jim van Os,Behrooz Z. Alizadeh,Thérèse van Amelsvoort,Agna A. Bartels-Velthuis,Richard Bruggeman,Nico J. van Beveren,Jurjen J. Luykx,Wiepke Cahn,Claudia Simons,René S. Kahn,Frederike Schirmbeck,Ruud van Winkel,Abraham Reichenberg
摘要
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 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, i.e., shared genetic and/or shared environmental, liability for psychotic disorders. Nevertheless, potentially modifiable illness-related factors account for a significant portion of the cognitive impairment in psychotic disorders.