Models of mild cognitive deficits in risk assessment in early psychosis.

Journal: Psychological medicine

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Affiliated Institutions:  Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai , People's Republic of China. Shanghai Xinlianxin Psychological Counseling Co., Ltd, Shanghai, China. Department of Automation, Shanghai Jiao Tong University, Shanghai , China. Big Data Research Lab, University of Waterloo, Waterloo, ON, Canada.

Abstract summary 

Mild cognitive deficits (MCD) emerge before the first episode of psychosis (FEP) and persist in the clinical high-risk (CHR) stage. This study aims to refine risk prediction by developing MCD models optimized for specific early psychosis stages and target populations.A comprehensive neuropsychological battery assessed 1059 individuals with FEP, 794 CHR, and 774 matched healthy controls (HCs). CHR subjects, followed up for 2 years, were categorized into converters (CHR-C) and non-converters (CHR-NC). The MATRICS Consensus Cognitive Battery standardized neurocognitive tests were employed.Both the CHR and FEP groups exhibited significantly poorer performance compared to the HC group across all neurocognitive tests (all < 0.001). The CHR-C group demonstrated poorer performance compared to the CHR-NC group on three sub-tests: visuospatial memory ( < 0.001), mazes ( = 0.005), and symbol coding ( = 0.023) tests. Upon adjusting for sex and age, the performance of the MCD model was excellent in differentiating FEP from HC, as evidenced by an Area Under the Receiver Operating Characteristic Curve (AUC) of 0.895 ( < 0.001). However, when applied in the CHR group for predicting CHR-C (AUC = 0.581, = 0.008), the performance was not satisfactory. To optimize the efficiency of psychotic risk assessment, three distinct MCD models were developed to distinguish FEP from HC, predict CHR-C from CHR-NC, and identify CHR from HC, achieving accuracies of 89.3%, 65.6%, and 80.2%, respectively.The MCD exhibits variations in domains, patterns, and weights across different stages of early psychosis and diverse target populations. Emphasizing precise risk assessment, our findings highlight the importance of tailored MCD models for different stages and risk levels.

Authors & Co-authors:  Zhang Cui Tang Xu Wei Hu Tang Wang Liu Chen Li Wang

Study Outcome 

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Citations : 
Authors :  12
Identifiers
Doi : 10.1017/S0033291724000382
SSN : 1469-8978
Study Population
Male,Female
Mesh Terms
Other Terms
cognition;prediction;schizophrenia;transition;ultra-high risk
Study Design
Study Approach
Country of Study
Publication Country
England