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Neuropsychological decline in schizophrenia from the premorbid to the postonset period: evidence from a population-representative longitudinal study.

Publication ,  Journal Article
Meier, MH; Caspi, A; Reichenberg, A; Keefe, RSE; Fisher, HL; Harrington, H; Houts, R; Poulton, R; Moffitt, TE
Published in: Am J Psychiatry
January 2014

OBJECTIVE: Despite the widespread belief that neuropsychological decline is a cardinal feature of the progression from the premorbid stage to the chronic form of schizophrenia, few longitudinal studies have examined change in neuropsychological functioning from before to after illness onset. The authors examined whether neuropsychological decline is unique to schizophrenia, whether it is generalized or confined to particular mental functions, and whether individuals with schizophrenia also have cognitive problems in everyday life. METHOD: Participants were members of a representative cohort of 1,037 individuals born in Dunedin, New Zealand, in 1972 and 1973 and followed prospectively to age 38, with 95% retention. Assessment of IQ and specific neuropsychological functions was conducted at ages 7, 9, 11, and 13, and again at age 38. Informants also reported on any cognitive problems at age 38. RESULTS: Individuals with schizophrenia exhibited declines in IQ and in a range of mental functions, particularly those tapping processing speed, learning, executive function, and motor function. There was little evidence of decline in verbal abilities or delayed memory, however, and the developmental progression of deficits in schizophrenia differed across mental functions. Processing speed deficits increased gradually from childhood to beyond the early teen years, whereas verbal deficits emerged early but remained static thereafter. Neuropsychological decline was specific to schizophrenia, as no evidence of decline was apparent among individuals with persistent depression, children with mild cognitive impairment, individuals matched on childhood risk factors for schizophrenia, and psychiatrically healthy individuals. Informants also noticed more cognitive problems in individuals with schizophrenia. CONCLUSIONS: There is substantial neuropsychological decline in schizophrenia from the premorbid to the postonset period, but the extent and developmental progression of decline varies across mental functions. Findings suggest that different pathophysiological mechanisms may underlie deficits in different mental functions.

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Published In

Am J Psychiatry

DOI

EISSN

1535-7228

Publication Date

January 2014

Volume

171

Issue

1

Start / End Page

91 / 101

Location

United States

Related Subject Headings

  • Schizophrenic Psychology
  • Schizophrenia
  • Psychiatry
  • New Zealand
  • Neuropsychological Tests
  • Memory
  • Male
  • Longitudinal Studies
  • Intelligence
  • Humans
 

Citation

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Meier, M. H., Caspi, A., Reichenberg, A., Keefe, R. S. E., Fisher, H. L., Harrington, H., … Moffitt, T. E. (2014). Neuropsychological decline in schizophrenia from the premorbid to the postonset period: evidence from a population-representative longitudinal study. Am J Psychiatry, 171(1), 91–101. https://doi.org/10.1176/appi.ajp.2013.12111438
Meier, Madeline H., Avshalom Caspi, Abraham Reichenberg, Richard S. E. Keefe, Helen L. Fisher, HonaLee Harrington, Renate Houts, Richie Poulton, and Terrie E. Moffitt. “Neuropsychological decline in schizophrenia from the premorbid to the postonset period: evidence from a population-representative longitudinal study.Am J Psychiatry 171, no. 1 (January 2014): 91–101. https://doi.org/10.1176/appi.ajp.2013.12111438.
Meier MH, Caspi A, Reichenberg A, Keefe RSE, Fisher HL, Harrington H, et al. Neuropsychological decline in schizophrenia from the premorbid to the postonset period: evidence from a population-representative longitudinal study. Am J Psychiatry. 2014 Jan;171(1):91–101.
Meier, Madeline H., et al. “Neuropsychological decline in schizophrenia from the premorbid to the postonset period: evidence from a population-representative longitudinal study.Am J Psychiatry, vol. 171, no. 1, Jan. 2014, pp. 91–101. Pubmed, doi:10.1176/appi.ajp.2013.12111438.
Meier MH, Caspi A, Reichenberg A, Keefe RSE, Fisher HL, Harrington H, Houts R, Poulton R, Moffitt TE. Neuropsychological decline in schizophrenia from the premorbid to the postonset period: evidence from a population-representative longitudinal study. Am J Psychiatry. 2014 Jan;171(1):91–101.
Journal cover image

Published In

Am J Psychiatry

DOI

EISSN

1535-7228

Publication Date

January 2014

Volume

171

Issue

1

Start / End Page

91 / 101

Location

United States

Related Subject Headings

  • Schizophrenic Psychology
  • Schizophrenia
  • Psychiatry
  • New Zealand
  • Neuropsychological Tests
  • Memory
  • Male
  • Longitudinal Studies
  • Intelligence
  • Humans