Do Cognitive Subtypes Exist in People at Clinical High Risk for Psychosis? Results From the EU-GEI Study.

Autor:	Gifford G; Department of Psychiatry, University of Oxford, Oxford, UK.; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK., Avila A; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.; Faculty of Medicine, Universidade Católica de Lisboa, Lisbon, Portugal., Kempton MJ; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK., Fusar-Poli P; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.; Outreach and Support in South-London (OASIS) Service, South London and Maudlsey (SLaM) NHS Foundation Trust, London, UK.; Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University (LMU), Munich, Germany., McCutcheon RA; Department of Psychiatry, University of Oxford, Oxford, UK., Coutts F; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK., Tognin S; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK., Valmaggia L; Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK., de Haan L; Department Early Psychosis, AMC, Academic Psychiatric Centre, Amsterdam, The Netherlands., van der Gaag M; Department of Clinical Psychology, Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, The Netherlands.; EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands.; Parnassia Psychiatric Institute, Department of Psychosis Research, The Hague, The Netherlands., Nelson B; Orygen, Victoria, Melbourne, Australia.; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia., Pantelis C; Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Carlton South, Vic, Australia., Riecher-Rössler A; Medical Faculty, University of Basel, Basel, Switzerland., Bressan R; Department of Psychiatry, Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil., Barrantes-Vidal N; Departamento de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Spanish Mental Health Research Network (CIBERSAM), Barcelona, Spain., Krebs MO; University Paris Descartes, Hôpital Sainte-Anne, C'JAAD, Service Hospitalo-Universitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557), Paris, France., Glenthøj B; Centre for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric SchizophreSnia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Ruhrmann S; Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany., Sachs G; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria., Rutten BPF; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands., van Os J; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands., Eu-Gei High Risk Study; Department of Psychiatry, University of Oxford, Oxford, UK., McGuire P; Department of Psychiatry, University of Oxford, Oxford, UK.; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Jazyk:	angličtina
Zdroj:	Schizophrenia bulletin [Schizophr Bull] 2024 Jul 25. Date of Electronic Publication: 2024 Jul 25.
DOI:	10.1093/schbul/sbae133
Abstrakt:	Background and Hypothesis: Cognition has been associated with socio-occupational functioning in individuals at Clinical High Risk for Psychosis (CHR-P). The present study hypothesized that clustering CHR-P participants based on cognitive data could reveal clinically meaningful subtypes. Study Design: A cohort of 291 CHR-P subjects was recruited through the multicentre EU-GEI high-risk study. We explored whether an underlying cluster structure was present in the cognition data. Clustering of cognition data was performed using k-means clustering and density-based spatial clustering of applications with noise. Cognitive subtypes were validated by comparing differences in functioning, psychosis symptoms, transition outcome, and grey matter volume between clusters. Network analysis was used to further examine relationships between cognition scores and clinical symptoms. Study Results: No underlying cluster structure was found in the cognitive data. K-means clustering produced "spared" and "impaired" cognition clusters similar to those reported in previous studies. However, these clusters were not associated with differences in functioning, symptomatology, outcome, or grey matter volume. Network analysis identified cognition and symptoms/functioning measures that formed separate subnetworks of associations. Conclusions: Stratifying patients according to cognitive performance has the potential to inform clinical care. However, we did not find evidence of cognitive clusters in this CHR-P sample. We suggest that care needs to be taken in inferring the existence of distinct cognitive subtypes from unsupervised learning studies. Future research in CHR-P samples could explore the existence of cognitive subtypes across a wider range of cognitive domains. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.)
Databáze:	MEDLINE
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