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Schizophrenia Bulletin Advance Access published online on April 9, 2007
Schizophrenia Bulletin, doi:10.1093/schbul/sbm020
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© The Author 2007. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

The Course of Neurocognition and Social Functioning in Individuals at Ultra High Risk for Psychosis

Tara A. Niendam1,2, Carrie E. Bearden3, Jamie Zinberg2, Jennifer K. Johnson4, Mary O'Brien3 and Tyrone D. Cannon2,3
2 Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563
3 Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Box 956968, Los Angeles, CA 90095-6968
4 Department of Psychiatry, Stanford University School of Medicine, 701A Welch Road, Suite 3325, Stanford, CA 94304

1 To whom correspondence should be addressed; tel: 310-794-9673, fax: 310-794-9740, e-mail: tniendam{at}ucla.edu.

Objective: This study evaluates longitudinal neuropsychological performance and its association with clinical symptomatology and psychosocial outcome in individuals identified as ultra high risk (UHR) for psychosis. Methods: Thirty-five UHR individuals completed neurocognitive, clinical, and social/role functioning assessments at baseline and, on average, 8.3 months later. Results: UHR subjects showed significant cognitive deficits at baseline and 2 distinct profiles of cognitive change over time. On average, 50% demonstrated improvement in social and role functioning over the follow-up period, while the other half showed either stability or decline in functioning. Functional improvement was associated with improved processing speed and visual memory, as well as improvement in clinical symptoms over the follow-up period. In contrast, patients who did not improve functionally showed stable clinical symptoms and cognitive performance over time. Conclusions: Although the degree of neurocognitive deficit at baseline in UHR patients does not predict psychosocial outcome, the course of neurocognitive change over the first 8 months of follow-up does differentiate patients with good and poor functional outcomes.

Keywords: prodrome / cognition / high risk / social functioning / functional outcome / psychosis


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