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Cognitive development prior to onset of psychosis

Published online by Cambridge University Press:  24 July 2017

J. Mollon  and
A. Reichenberg
J. Mollon*
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
A. Reichenberg
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK Departments of Psychiatry, Preventive Medicine and the Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, USA
*
*Address for correspondence: J. Mollon, Ph.D., Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London SE5 8AF, UK. (E-mail: josephine.j.mollon@kcl.ac.uk)
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Abstract

Schizophrenia patients commonly exhibit substantial and diffuse cognitive impairment. Evidence suggests that subtle cognitive deficits are already apparent in childhood and adolescence, many years prior to onset of psychosis. While there is almost unequivocal evidence of some degree of cognitive impairment in individuals who later develop schizophrenia, the literature remains inconclusive regarding the exact nature of this impairment and warrants careful review and interpretation. Meta-analytic findings suggest that individuals who later develop schizophrenia, but not related disorders, such as bipolar disorder, exhibit a premorbid IQ deficit of around 8 points. Several studies have also found evidence for premorbid deficits across most cognitive domains, such as language, processing speed and executive functions. Longitudinal studies, although rare, suggest that individuals who go on to develop schizophrenia may show a course of increasing cognitive impairment prior to onset of psychosis. While evidence regarding the etiology of premorbid deficits is scarce, common and rare genetic variants, as well as environmental factors such as obstetric complications and cannabis use may play an important role and warrant further examination. In this selected review, we give an overview of population-based studies on premorbid cognitive deficits in schizophrenia, with a special focus on evidence regarding the specificity, profile and course of these deficits.

Keywords

Cognitionneurodevelopmentpsychosisschizophrenia
Type
Review Article
Information
Psychological Medicine , Volume 48 , Issue 3 , February 2018 , pp. 392 - 403
Copyright
Copyright © Cambridge University Press 2017 

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