Intelligence trajectories in individuals at ultra-high risk for psychosis: An 8-year longitudinal analysis

Background: Cognitive impairment is a well-documented predictor of transition to a full-threshold psychotic disorder amongst individuals at ultra-high risk (UHR) for psychosis. However, less is known about whether change in cognitive functioning differs between those who do and do not transition to a psychotic disorder. Studies to date have not examined trajectories in intelligence constructs (e.g., acquired knowledge and fluid intelligence), which have demonstrated marked impairments in individuals with schizophrenia. This study aimed to examine intelligence trajectories using longitudinal data from three time-points, spanning an average of eight years.Methods: Participants (N=139) at UHR for psychosis completed the Wechsler Abbreviated Scale of Intelligence (WASI) at each follow-up. Linear mixed-effects models mapped changes in WASI Full-Scale IQ (FSIQ) and T-scores on Vocabulary, Similarities, Block Design, and Matrix Reasoning subtests.Results: The sample showed stable and improving trajectories for FSIQ and all subtests. There were no significant differences in trajectories between those who did and did not transition to psychosis and between individuals with good and poor functional outcomes. However, although not significant, the trajectories of the acquired knowledge subtests diverged between transitioned and non-transitioned individuals (β=−0.12, 95% CI [−0.29, 0.05] for Vocabulary and β=−0.14, 95% CI [−0.33, 0.05] for Similarities). Conclusions: There was no evidence for long-term deterioration in intelligence trajectories in this UHR sample. As the small sample of individuals who transitioned may have limited our ability to detect subtle differences, future studies with larger sample sizes are needed to explore potential differences in intelligence trajectories between UHR transition groups.

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Childhood maltreatment and transition to psychotic disorder independently predict long-term functioning in young people at ultra-high risk for psychosis

Psychological Medicine ◽

10.1017/s003329171500135x ◽

2015 ◽

Vol 45 (16) ◽

pp. 3453-3465 ◽

Cited By ~ 34

Author(s):

A. R. Yung ◽

J. Cotter ◽

S. J. Wood ◽

P. McGorry ◽

A. D. Thompson ◽

...

Keyword(s):

At Risk ◽

High Risk ◽

Functional Outcome ◽

Psychotic Disorder ◽

Childhood Maltreatment ◽

History Of Childhood ◽

Ultra High Risk ◽

History Of

Background.Individuals identified as at ultra-high risk (UHR) for psychosis are at risk of poor functional outcome regardless of development of psychotic disorder. Studies examining longitudinal predictors of poor functioning have tended to be small and report only medium-term follow-up data. We sought to examine clinical predictors of functional outcome in a long-term longitudinal study.Method.Participants were 268 (152 females, 116 males) individuals identified as UHR 2–14 years previously. A range of clinical and sociodemographic variables were assessed at baseline. Functioning at follow-up was assessed using the Social and Occupational Functioning Assessment Scale (SOFAS).Results.Baseline negative symptoms, impaired emotional functioning, disorders of thought content, low functioning, past substance use disorder and history of childhood maltreatment predicted poor functioning at follow-up in univariate analyses. Only childhood maltreatment remained significant in the multivariate analysis (p < 0.001). Transition to psychosis was also significantly associated with poor functioning at long-term follow-up [mean SOFAS score 59.12 (s.d. = 18.54) in the transitioned group compared to 70.89 (s.d. = 14.00) in the non-transitioned group, p < 0.001]. Childhood maltreatment was a significant predictor of poor functioning in both the transitioned and non-transitioned groups.Conclusions.Childhood maltreatment and transition to psychotic disorder independently predicted poor long-term functioning. This suggests that it is important to assess history of childhood maltreatment in clinical management of UHR individuals. The finding that transition to psychosis predicts poor long-term functioning strengthens the evidence that the UHR criteria detect a subgroup at risk for schizophrenia.

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Poster #T223 AXIS I AND AXIS II DISORDERS IN YOUNG PEOPLE AT ULTRA-HIGH RISK OF DEVELOPING A PSYCHOTIC DISORDER: A LONG-TERM FOLLOW UP STUDY

Schizophrenia Research ◽

10.1016/s0920-9964(14)71039-4 ◽

2014 ◽

Vol 153 ◽

pp. S368-S369

Author(s):

Anneliese E. Spiteri-Staines ◽

Alison R. Yung ◽

Paul G. Amminger ◽

Stephen Wood ◽

Ashleigh Lin ◽

...

Keyword(s):

High Risk ◽

Young People ◽

Psychotic Disorder ◽

Axis Ii ◽

Follow Up Study ◽

Ultra High Risk ◽

Long Term Follow Up ◽

Axis I

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LONG TERM FOLLOW UP OF AN ULTRA HIGH RISK ("PRODROMAL") GROUP

Schizophrenia Research ◽

10.1016/j.schres.2010.02.218 ◽

2010 ◽

Vol 117 (2-3) ◽

pp. 179 ◽

Cited By ~ 2

Author(s):

Barnaby Nelson ◽

Alison R. Yung ◽

Hok Pan Yuen ◽

Daniela Spiliotacopoulos ◽

Ashleigh Lin ◽

...

Keyword(s):

High Risk ◽

Ultra High Risk ◽

Long Term Follow Up

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Neurocognitive and Clinical Predictors of Long-Term Outcome in Adolescents at Ultra-High Risk for Psychosis: A 6-Year Follow-Up

PLoS ONE ◽

10.1371/journal.pone.0093994 ◽

2014 ◽

Vol 9 (4) ◽

pp. e93994 ◽

Cited By ~ 54

Author(s):

Tim Ziermans ◽

Sanne de Wit ◽

Patricia Schothorst ◽

Mirjam Sprong ◽

Herman van Engeland ◽

...

Keyword(s):

High Risk ◽

Clinical Predictors ◽

Term Outcome ◽

Long Term Outcome ◽

Ultra High Risk

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Neurocognitive predictors of transition to psychosis: medium- to long-term findings from a sample at ultra-high risk for psychosis

Psychological Medicine ◽

10.1017/s0033291713000123 ◽

2013 ◽

Vol 43 (11) ◽

pp. 2349-2360 ◽

Cited By ~ 26

Author(s):

A. Lin ◽

A. R. Yung ◽

B. Nelson ◽

W. J. Brewer ◽

R. Riley ◽

...

Keyword(s):

High Risk ◽

Cox Regression ◽

Early Stage ◽

Strong Predictor ◽

Neurocognitive Performance ◽

Ultra High Risk ◽

Picture Completion ◽

Healthy Control ◽

Matrix Reasoning

BackgroundIndividuals at ultra-high risk (UHR) for psychosis show reduced neurocognitive performance across domains but it is unclear which reductions are associated with transition to frank psychosis. The aim of this study was to investigate differences in baseline neurocognitive performance between UHR participants with (UHR-P) and without transition to psychosis (UHR-NP) and a healthy control (HC) group and examine neurocognitive predictors of transition over the medium to long term.MethodA sample of 325 UHR participants recruited consecutively from the Personal Assessment and Crisis Evaluation (PACE) Clinic in Melbourne and 66 HCs completed a neurocognitive assessment at baseline. The UHR group was followed up between 2.39 and 14.86 (median = 6.45) years later. Cox regression was used to investigate candidate neurocognitive predictors of psychosis onset.ResultsThe UHR group performed more poorly than the HC group across a range of neurocognitive domains but only performance on digit symbol coding and picture completion differed between the groups. The risk of transition was only significantly associated with poorer performance on visual reproduction [hazard ratio (HR) 0.919, 95% confidence interval (CI) 0.876–0.965, p = 0.001] and matrix reasoning (HR 0.938, 95% CI 0.883–0.996, p = 0.037). These remained significant even after controlling for psychopathology at baseline.ConclusionsThis study is the longest follow-up of an UHR sample to date. UHR status was associated with poorer neurocognitive performance compared to HCs on some tasks. Cognition at identification as UHR was not a strong predictor of risk for transition to psychosis. The results suggests the need to include more experimental paradigms that isolate discrete cognitive processes to better understand neurocognition at this early stage of illness.

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Surgically accelerated orthodontic techniques and periodontal response: a systematic review

European Journal of Orthodontics ◽

10.1093/ejo/cjz103 ◽

2020 ◽

Vol 42 (6) ◽

pp. 635-642 ◽

Cited By ~ 3

Author(s):

Umar Rekhi ◽

Raisa Queiroz Catunda ◽

Monica Prasad Gibson

Keyword(s):

Systematic Review ◽

High Risk ◽

Sample Size ◽

Orthodontic Treatment ◽

Small Sample Size ◽

Small Sample ◽

Risk Of Bias ◽

Long Term Follow Up

Summary Background Reduction in orthodontic treatment time is gaining popularity due to patient demands. Several new techniques of acceleratory orthodontic treatment have been introduced to effectively treat the malocclusion in a shorter time period with minimal adverse effects. Objective The objective of this systematic review is to critically evaluate the potential effect of accelerated surgically assisted orthodontic techniques on periodontal tissues. Materials and methods Electronic databases used to perform the search were Medline (Ovid), EMBASE, PubMed, Scopus, Cochrane, Google Scholar, and hand searching of the literature was also performed. Selection criteria Only randomized control trials (RCTs) that assessed the relationship between accelerated surgically assisted orthodontic techniques and its effects on periodontium were included. Data collection and analysis The Joanna Briggs Institute (JBI) critical appraisal checklist tool (2016) was used to assess the finally selected studies. Among these studies, five evaluated corticotomy-facilitated orthodontics, two tested accelerated tooth movement with piezocision, one compared corticotomy-facilitated orthodontics with piezocision, and one studied the effects of periodontally accelerated osteogenic orthodontics. The duration of these studies was relatively short and had moderate to high risk of bias. Results Literature search identified 225 records from 5 databases and 50 articles from the partial grey literature (Google scholar) search. Finally, nine eligible RCTs were included in the review. Limitations Most of the included studies were of a high risk of bias due to high experimental heterogeneity and small sample size. Long-term follow-up of the periodontal response to these interventions was also lacking. Conclusions There is an absence of evidence considering the lack of long-term follow-up and small sample size therefore, the results of this review should be carefully interpreted. Implications Due to the need for more studies with less risk of bias, these techniques should be implemented in dental practice with caution. With stronger evidence, the study may be confirmed to provide quicker desired results for orthodontic patients. Registration This study protocol was not registered. Funding No funding was obtained for this systematic review.

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Baseline grey matter volume of non-transitioned “ultra high risk” for psychosis individuals with and without attenuated psychotic symptoms at long-term follow-up

Schizophrenia Research ◽

10.1016/j.schres.2015.05.014 ◽

2016 ◽

Vol 173 (3) ◽

pp. 152-158 ◽

Cited By ~ 22

Author(s):

Vanessa L. Cropley ◽

Ashleigh Lin ◽

Barnaby Nelson ◽

Renate L.E.P. Reniers ◽

Alison R. Yung ◽

...

Keyword(s):

High Risk ◽

Grey Matter ◽

Psychotic Symptoms ◽

Grey Matter Volume ◽

Matter Volume ◽

Ultra High Risk ◽

Long Term Follow Up

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M22. IGG ANTIBODIES TO TOXOPLASMA GONDII ARE ASSOCIATED WITH INCREASED LONG-TERM RISK FOR PSYCHOSIS IN INDIVIDUALS AT ULTRA-HIGH RISK FOR PSYCHOSIS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa030.334 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S141-S142

Author(s):

Maximus Berger ◽

Eva Burkhardt ◽

Alison Yung ◽

Barnaby Nelson ◽

Shona Francey ◽

...

Keyword(s):

Risk Factor ◽

High Risk ◽

Toxoplasma Gondii ◽

Young People ◽

Igg Antibodies ◽

Ultra High Risk ◽

Antibody Titers ◽

Parasitic Pathogens

Abstract Background The prevalence of antibodies to Toxoplasma gondii, a ubiquitous parasitic protozoan causing the infectious disease toxoplasmosis, is increased in patients with psychotic disorders compared to the general population. We have previously shown that antibody titers for T.gondii correlate with the severity of positive symptoms in young people at ultra-high risk (UHR) for psychosis, suggesting that infection with T. gondii may be relevant to the manifestation of psychosis. However, it is unclear if T. gondii antibodies represent a risk factor for psychosis onset or non-psychotic outcome in UHR individuals. The aim of the present study was to examine whether seropositivity for T.gondii is associated with transition to psychosis and other outcomes in young people at UHR for psychosis. Methods The study sample consisted of 96 individuals at UHR for psychosis who were referred to the Personal Assistance and Crisis Evaluation (PACE) clinic in Melbourne, Australia, between 2001 and 2004, consented to optional blood tests for infectious agents and were followed up for up to 10 years after baseline (median (interquartile range) duration of follow-up: 7.15 (3.14 – 7.72) years). Serum IgG antibodies to six viral and parasitic pathogens (Toxoplasma gondii, Herpes Simplex Virus Type 1 and 2, Cytomegalovirus, Epstein Barr Virus, Varicella-Zoster Virus) were measured at baseline. Outcome measures included transition to psychosis, general psychiatric symptomatology and positive psychotic symptoms (BPRS), negative symptoms (SANS), depressive symptoms (HAM-D), anxiety symptoms (HAM-A) and functioning (SOFAS and GAF). Cox proportional hazards regression and linear regression models were used to examine the associations of seropositivity and antibody titers at baseline and transition to psychosis and other outcomes at follow-up. Results A total of 17 individuals (17.7%) were seropositive for Toxoplasma gondii at baseline. The rate of transition to psychosis was higher among seropositive (35.7%) compared to seronegative participants (14.6%), although this was not statistically significant (p=0.101). Antibody titers (IgG) for Toxoplasma gondii were significantly higher at baseline in participants who later transitioned to psychosis (1.34 ± 1.36 vs. 0.79 ± 0.73, p=0.027). Seropositivity for T.gondii IgG at baseline significantly predicted transition to psychosis within the follow-up duration (hazard ratio [HR]=3.61, 95%CI 1.08 – 12.00, p=0.036). Toxoplasma IgG at baseline were significantly associated with higher BPRS scores at follow-up in participants who were seropositive at baseline (Beta=6.38, 95%CI 0.43 – 12.34, p=0.038). No significant associations were found between antibodies to other pathogens and outcome, or between antibodies to Toxoplasma gondii and any other outcomes. Discussion Our findings suggest that the presence of IgG class antibodies for Toxoplasma gondii is associated with a higher risk for psychosis transition in individuals at UHR for psychosis, but not with risk for other long-term outcomes. These observations provide support for the hypothesis that infection with Toxoplasma gondii may be an environmental risk factor for psychosis and suggest that IgG antibodies for Toxoplasma gondii in individuals at UHR for psychosis have prognostic relevance.

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