Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings

Eva Velthorst; Josephine Mollon; EU-GEI High Risk Study; Robin M. Murray; Lieuwe de Haan; Inez Myin Germeys; David C. Glahn; Celso Arango; Els van der Ven; Marta Di Forti; Miguel Bernardo; Sinan Guloksuz; Philippe Delespaul; Gisela Mezquida; Silvia Amoretti; Julio Bobes; Pilar A. Saiz; María Paz García-Portilla; José Luis Santos; Estela Jiménez-López; Julio Sanjuan; Eduardo J. Aguilar; Manuel Arrojo; Angel Carracedo; Gonzalo López; Javier González-Peñas; Mara Parellada; Cem Atbaşoğlu; Meram Can Saka; Alp Üçok; Köksal Alptekin; Berna 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. Maric; Marina M. Mihaljevic; Sanja Andric Petrovic; Tijana Mirjanic; Cristina Marta Del-Ben; Laura Ferraro; Charlotte Gayer-Anderson; Peter B. Jones; Hannah E. Jongsma; James B. Kirkbride; Nico Van Beveren; Ruud van Winkel; A Reichenberg

doi:10.1038/s41380-020-00969-z

Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings

Eva Velthorst^*, Josephine Mollon, EU-GEI High Risk Study, Robin M. Murray, Lieuwe de Haan, Inez Myin Germeys, David C. Glahn, Celso Arango, Els van der Ven, Marta Di Forti, Miguel Bernardo, Sinan Guloksuz, Philippe Delespaul, Gisela Mezquida, Silvia Amoretti, Julio Bobes, Pilar A. Saiz, María Paz García-Portilla, José Luis Santos, Estela Jiménez-LópezJulio Sanjuan, Eduardo J. Aguilar, Manuel Arrojo, Angel Carracedo, Gonzalo López, Javier González-Peñas, Mara Parellada, Cem Atbaşoğlu, Meram Can Saka, Alp Üçok, Köksal Alptekin, Berna 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. Maric, Marina M. Mihaljevic, Sanja Andric Petrovic, Tijana Mirjanic, Cristina Marta Del-Ben, Laura Ferraro, Charlotte Gayer-Anderson, Peter B. Jones, Hannah E. Jongsma, James B. Kirkbride, Nico Van Beveren, Ruud van Winkel, A Reichenberg

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

24 Citations (Scopus)

Abstract

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.

Original language	English
Pages (from-to)	4529-4543
Number of pages	15
Journal	Molecular Psychiatry
Volume	26
Issue number	8
Early online date	7 Jan 2021
DOIs	https://doi.org/10.1038/s41380-020-00969-z
Publication status	Published - Aug 2021

Bibliographical note

Funding Information:
Acknowledgements The European Community’s Seventh Framework Programme under grant agreement No. HEALTH-F2-2010-241909 (EU-GEI). The Geestkracht programme of the Dutch Health Research Council (Zon-Mw)(GROUP). Dr. Velthorst is supported by The Seaver Foundation. Dr. Pantelis was supported by a NHMRC Senior Principal Research Fellowship (ID: 1105825), a NHMRC Program Grant (ID: 1150083). The Melbourne arm of the study was supported by a grant from the Australian National Health & Medical Research Council (NHMRC-EU grant ID: 567215). The French cohort was supported by the French Ministry grant (PHRC ICAAR - AOM07-118). The Spanish sample was supported by the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III (SAM16PE07CP1, PI16/02012, PI19/024), Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), Fundación Familia Alonso and Fundación Alicia Koplowitz. The Brazilian sample was supported by FAPESP-Brazil (grant 2012/05178-0). Additional support was provided by a Medical Research Council Fellowship to Dr. Kempton (grant MR/ J008915/1). Dr. Kirkbride was supported by the National Institute for Health Research University College London Hospital Biomedical Research Centre. Dr. Nelson was supported by an NHMRC Senior Research Fellowship (1137687). We would like to thank the EU-GEI WP2 Group not mentioned in main author list: Kathryn Hubbard, Stephanie Beards, Simona A. Stilo, Pedro Cuadrado, José Juan Rodríguez Solano, David Fraguas, Álvaro Andreu-Bernabeu, Gonzalo López, Bibi-ana Cabrera, Juan Nacher, Javier Costas, Mario Matteis [8], Marta Rapado-Castro, Emiliano González, Covadonga M. Díaz-Caneja [8], Emilio Sánchez, Manuel Durán-Cutilla, Nathalie Franke, Fabian Ter-morshuizen, Daniella van Dam, Elles Messchaart, Marion Leboyer [4], Franck Schurḧ off, Stéphane Jamain, Grégoire Baudin, Aziz Ferchiou, Baptiste Pignon, Jean-Romain Richard, Thomas Charpeaud, Anne-Marie Tronche, Flora Frijda, Giovanna Marrazzo, Crocettarachele Sartorio, Fabio Seminerio, Camila Marcelino Loureiro, Rosana Shuhama, Mirella Ruggeri, Chiara Bonetto, Doriana Cristofalo, Domenico Berardi, Marco Seri, Elena Bonora, Anastasios Nougus, Giuseppe D’Andrea, Laura Ferraro, Giada Tripoli, Ulrich Reininghaus, Enrique García Bernardo, Laura Roldán, Esther Lorente-Rovira, Ma Soledad Olmeda, Daniele La Barbera, Cristina M. Del-Ben, Lucia Sideli. Study funders contributed to the salaries of the research workers employed, but did not participate in the study design, data analyses, data interpretation, or writing of the manuscript. All authors had full access to the study data and had final responsibility for the decision to submit for publication.

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© 2021, The Author(s), under exclusive licence to Springer Nature Limited.

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https://pure.rug.nl/ws/files/157942700/Cognitive_functioning_throughout_adulthood_and_illness_stages_in_individuals_with_psychotic_disorders_and_their_unaffected_siblings.pdfLicence: Article 25fa Dutch Copyright Act

Cite this

Velthorst, E., Mollon, J., EU-GEI High Risk Study, Murray, R. M., de Haan, L., Germeys, I. M., Glahn, D. C., Arango, C., van der Ven, E., Di Forti, M., Bernardo, M., Guloksuz, S., Delespaul, P., Mezquida, G., Amoretti, S., Bobes, J., Saiz, P. A., García-Portilla, M. P., Santos, J. L., ... Reichenberg, A. (2021). Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings. Molecular Psychiatry, 26(8), 4529-4543. https://doi.org/10.1038/s41380-020-00969-z

@article{bdd8b34921a542cb947389dbaa36d45c,

title = "Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings",

abstract = "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.",

author = "Eva Velthorst and Josephine Mollon and {EU-GEI High Risk Study} and Murray, {Robin M.} and {de Haan}, Lieuwe and Germeys, {Inez Myin} and Glahn, {David C.} and Celso Arango and {van der Ven}, Els and {Di Forti}, Marta and Miguel Bernardo and Sinan Guloksuz and Philippe Delespaul and Gisela Mezquida and Silvia Amoretti and Julio Bobes and Saiz, {Pilar A.} and Garc{\'i}a-Portilla, {Mar{\'i}a Paz} and Santos, {Jos{\'e} Luis} and Estela Jim{\'e}nez-L{\'o}pez and Julio Sanjuan and Aguilar, {Eduardo J.} and Manuel Arrojo and Angel Carracedo and Gonzalo L{\'o}pez and Javier Gonz{\'a}lez-Pe{\~n}as and Mara Parellada and Cem Atba{\c s}oğlu and Saka, {Meram Can} and Alp {\"U}{\c c}ok and K{\"o}ksal Alptekin and Berna Akdede and Tolga Binbay and Vesile Altınyazar and Halis Ula{\c s} and Berna Yalın{\c c}etin and G{\"u}vem G{\"u}m{\"u}{\c s}-Akay and Beyaz, {Bur{\c c}in Cihan} and Haldun Soyg{\"u}r and Cankurtaran, {Eylem {\c S}ahin} and Kaymak, {Semra Ulusoy} and Maric, {Nadja P.} and Mihaljevic, {Marina M.} and Petrovic, {Sanja Andric} and Tijana Mirjanic and Del-Ben, {Cristina Marta} and Laura Ferraro and Charlotte Gayer-Anderson and Jones, {Peter B.} and Jongsma, {Hannah E.} and Kirkbride, {James B.} and {Van Beveren}, Nico and {van Winkel}, Ruud and A Reichenberg",

note = "Funding Information: Acknowledgements The European Community{\textquoteright}s Seventh Framework Programme under grant agreement No. HEALTH-F2-2010-241909 (EU-GEI). The Geestkracht programme of the Dutch Health Research Council (Zon-Mw)(GROUP). Dr. Velthorst is supported by The Seaver Foundation. Dr. Pantelis was supported by a NHMRC Senior Principal Research Fellowship (ID: 1105825), a NHMRC Program Grant (ID: 1150083). The Melbourne arm of the study was supported by a grant from the Australian National Health & Medical Research Council (NHMRC-EU grant ID: 567215). The French cohort was supported by the French Ministry grant (PHRC ICAAR - AOM07-118). The Spanish sample was supported by the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III (SAM16PE07CP1, PI16/02012, PI19/024), Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), Fundaci{\'o}n Familia Alonso and Fundaci{\'o}n Alicia Koplowitz. The Brazilian sample was supported by FAPESP-Brazil (grant 2012/05178-0). Additional support was provided by a Medical Research Council Fellowship to Dr. Kempton (grant MR/ J008915/1). Dr. Kirkbride was supported by the National Institute for Health Research University College London Hospital Biomedical Research Centre. Dr. Nelson was supported by an NHMRC Senior Research Fellowship (1137687). We would like to thank the EU-GEI WP2 Group not mentioned in main author list: Kathryn Hubbard, Stephanie Beards, Simona A. Stilo, Pedro Cuadrado, Jos{\'e} Juan Rodr{\'i}guez Solano, David Fraguas, {\'A}lvaro Andreu-Bernabeu, Gonzalo L{\'o}pez, Bibi-ana Cabrera, Juan Nacher, Javier Costas, Mario Matteis [8], Marta Rapado-Castro, Emiliano Gonz{\'a}lez, Covadonga M. D{\'i}az-Caneja [8], Emilio S{\'a}nchez, Manuel Dur{\'a}n-Cutilla, Nathalie Franke, Fabian Ter-morshuizen, Daniella van Dam, Elles Messchaart, Marion Leboyer [4], Franck Schurḧ off, St{\'e}phane Jamain, Gr{\'e}goire Baudin, Aziz Ferchiou, Baptiste Pignon, Jean-Romain Richard, Thomas Charpeaud, Anne-Marie Tronche, Flora Frijda, Giovanna Marrazzo, Crocettarachele Sartorio, Fabio Seminerio, Camila Marcelino Loureiro, Rosana Shuhama, Mirella Ruggeri, Chiara Bonetto, Doriana Cristofalo, Domenico Berardi, Marco Seri, Elena Bonora, Anastasios Nougus, Giuseppe D{\textquoteright}Andrea, Laura Ferraro, Giada Tripoli, Ulrich Reininghaus, Enrique Garc{\'i}a Bernardo, Laura Rold{\'a}n, Esther Lorente-Rovira, Ma Soledad Olmeda, Daniele La Barbera, Cristina M. Del-Ben, Lucia Sideli. Study funders contributed to the salaries of the research workers employed, but did not participate in the study design, data analyses, data interpretation, or writing of the manuscript. All authors had full access to the study data and had final responsibility for the decision to submit for publication. Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Nature Limited.",

year = "2021",

month = aug,

doi = "10.1038/s41380-020-00969-z",

language = "English",

volume = "26",

pages = "4529--4543",

journal = "Molecular Psychiatry",

issn = "1359-4184",

publisher = "Springer Nature",

number = "8",

}

Velthorst, E, Mollon, J, EU-GEI High Risk Study, Murray, RM, de Haan, L, Germeys, IM, Glahn, DC, Arango, C, van der Ven, E, Di Forti, M, Bernardo, M, Guloksuz, S, Delespaul, P, Mezquida, G, Amoretti, S, Bobes, J, Saiz, PA, García-Portilla, MP, Santos, JL, Jiménez-López, E, Sanjuan, J, Aguilar, EJ, Arrojo, M, Carracedo, A, López, G, González-Peñas, J, Parellada, M, Atbaşoğlu, C, Saka, MC, Üçok, A, Alptekin, K, Akdede, B, Binbay, T, Altınyazar, V, Ulaş, H, Yalınçetin, B, Gümüş-Akay, G, Beyaz, BC, Soygür, H, Cankurtaran, EŞ, Kaymak, SU, Maric, NP, Mihaljevic, MM, Petrovic, SA, Mirjanic, T, Del-Ben, CM, Ferraro, L, Gayer-Anderson, C, Jones, PB, Jongsma, HE, Kirkbride, JB, Van Beveren, N, van Winkel, R & Reichenberg, A 2021, 'Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings', Molecular Psychiatry, vol. 26, no. 8, pp. 4529-4543. https://doi.org/10.1038/s41380-020-00969-z

TY - JOUR

T1 - Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings

AU - Velthorst, Eva

AU - Mollon, Josephine

AU - EU-GEI High Risk Study

AU - Murray, Robin M.

AU - de Haan, Lieuwe

AU - Germeys, Inez Myin

AU - Glahn, David C.

AU - Arango, Celso

AU - van der Ven, Els

AU - Di Forti, Marta

AU - Bernardo, Miguel

AU - Guloksuz, Sinan

AU - Delespaul, Philippe

AU - Mezquida, Gisela

AU - Amoretti, Silvia

AU - Bobes, Julio

AU - Saiz, Pilar A.

AU - García-Portilla, María Paz

AU - Santos, José Luis

AU - Jiménez-López, Estela

AU - Sanjuan, Julio

AU - Aguilar, Eduardo J.

AU - Arrojo, Manuel

AU - Carracedo, Angel

AU - López, Gonzalo

AU - González-Peñas, Javier

AU - Parellada, Mara

AU - Atbaşoğlu, Cem

AU - Saka, Meram Can

AU - Üçok, Alp

AU - Alptekin, Köksal

AU - Akdede, Berna

AU - Binbay, Tolga

AU - Altınyazar, Vesile

AU - Ulaş, Halis

AU - Yalınçetin, Berna

AU - Gümüş-Akay, Güvem

AU - Beyaz, Burçin Cihan

AU - Soygür, Haldun

AU - Cankurtaran, Eylem Şahin

AU - Kaymak, Semra Ulusoy

AU - Maric, Nadja P.

AU - Mihaljevic, Marina M.

AU - Petrovic, Sanja Andric

AU - Mirjanic, Tijana

AU - Del-Ben, Cristina Marta

AU - Ferraro, Laura

AU - Gayer-Anderson, Charlotte

AU - Jones, Peter B.

AU - Jongsma, Hannah E.

AU - Kirkbride, James B.

AU - Van Beveren, Nico

AU - van Winkel, Ruud

AU - Reichenberg, A

N1 - Funding Information: Acknowledgements The European Community’s Seventh Framework Programme under grant agreement No. HEALTH-F2-2010-241909 (EU-GEI). The Geestkracht programme of the Dutch Health Research Council (Zon-Mw)(GROUP). Dr. Velthorst is supported by The Seaver Foundation. Dr. Pantelis was supported by a NHMRC Senior Principal Research Fellowship (ID: 1105825), a NHMRC Program Grant (ID: 1150083). The Melbourne arm of the study was supported by a grant from the Australian National Health & Medical Research Council (NHMRC-EU grant ID: 567215). The French cohort was supported by the French Ministry grant (PHRC ICAAR - AOM07-118). The Spanish sample was supported by the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III (SAM16PE07CP1, PI16/02012, PI19/024), Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), Fundación Familia Alonso and Fundación Alicia Koplowitz. The Brazilian sample was supported by FAPESP-Brazil (grant 2012/05178-0). Additional support was provided by a Medical Research Council Fellowship to Dr. Kempton (grant MR/ J008915/1). Dr. Kirkbride was supported by the National Institute for Health Research University College London Hospital Biomedical Research Centre. Dr. Nelson was supported by an NHMRC Senior Research Fellowship (1137687). We would like to thank the EU-GEI WP2 Group not mentioned in main author list: Kathryn Hubbard, Stephanie Beards, Simona A. Stilo, Pedro Cuadrado, José Juan Rodríguez Solano, David Fraguas, Álvaro Andreu-Bernabeu, Gonzalo López, Bibi-ana Cabrera, Juan Nacher, Javier Costas, Mario Matteis [8], Marta Rapado-Castro, Emiliano González, Covadonga M. Díaz-Caneja [8], Emilio Sánchez, Manuel Durán-Cutilla, Nathalie Franke, Fabian Ter-morshuizen, Daniella van Dam, Elles Messchaart, Marion Leboyer [4], Franck Schurḧ off, Stéphane Jamain, Grégoire Baudin, Aziz Ferchiou, Baptiste Pignon, Jean-Romain Richard, Thomas Charpeaud, Anne-Marie Tronche, Flora Frijda, Giovanna Marrazzo, Crocettarachele Sartorio, Fabio Seminerio, Camila Marcelino Loureiro, Rosana Shuhama, Mirella Ruggeri, Chiara Bonetto, Doriana Cristofalo, Domenico Berardi, Marco Seri, Elena Bonora, Anastasios Nougus, Giuseppe D’Andrea, Laura Ferraro, Giada Tripoli, Ulrich Reininghaus, Enrique García Bernardo, Laura Roldán, Esther Lorente-Rovira, Ma Soledad Olmeda, Daniele La Barbera, Cristina M. Del-Ben, Lucia Sideli. Study funders contributed to the salaries of the research workers employed, but did not participate in the study design, data analyses, data interpretation, or writing of the manuscript. All authors had full access to the study data and had final responsibility for the decision to submit for publication. Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer Nature Limited.

PY - 2021/8

Y1 - 2021/8

N2 - 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.

AB - 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.

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U2 - 10.1038/s41380-020-00969-z

DO - 10.1038/s41380-020-00969-z

M3 - Article

C2 - 33414498

AN - SCOPUS:85099043499

SN - 1359-4184

VL - 26

SP - 4529

EP - 4543

JO - Molecular Psychiatry

JF - Molecular Psychiatry

IS - 8

ER -

Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings

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