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S63. CLINICAL AND DEVELOPMENTAL CHARACTERISTICS OF COGNITIVE SUBGROUPS IN A TRANSDIAGNOSTIC SAMPLE OF SCHIZOPHRENIA, SCHIZOAFFECTIVE DISORDER AND BIPOLAR DISORDER

BACKGROUND: Evidence suggests that neurocognitive dysfunction is a transdiagnostic feature of individuals across continuum between schizophrenia and bipolar disorder. However, there is a significant heterogeneity of neuropsychological and social cognitive abilities in schizophrenia, schizoaffective...

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Autores principales: Bora, Emre, Verim, Burcu, Akgul, Ozge, Ildız, Ayşegül, Alptekin, Köksal, Özerdem, Ayşegül, Akdede, Berna Binnur
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234221/
http://dx.doi.org/10.1093/schbul/sbaa031.129
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author Bora, Emre
Verim, Burcu
Akgul, Ozge
Ildız, Ayşegül
Alptekin, Köksal
Özerdem, Ayşegül
Akdede, Berna Binnur
author_facet Bora, Emre
Verim, Burcu
Akgul, Ozge
Ildız, Ayşegül
Alptekin, Köksal
Özerdem, Ayşegül
Akdede, Berna Binnur
author_sort Bora, Emre
collection PubMed
description BACKGROUND: Evidence suggests that neurocognitive dysfunction is a transdiagnostic feature of individuals across continuum between schizophrenia and bipolar disorder. However, there is a significant heterogeneity of neuropsychological and social cognitive abilities in schizophrenia, schizoaffective disorder and bipolar disorder. In recent years, several studies have investigated cognitive subgroups in schizophrenia-bipolar disorder continuum using data-driven methods and found that bipolar disorder includes several subgroups including a severely impaired and a neurocognitively intact clusters. However, neurodevelopmental and clinical characteristics of cognitive subgroups are not clear. METHODS: 147 clinically stable patients with schizophrenia, schizoaffective or bipolar disorder were assessed using clinical rating scales for current psychotic and affective symptoms, schizobipolar scale, and a comprehensive neuropsychological battery including measures of ToM (Hinting and Reading the mind from the Eyes (RMET) task)). Developmental history and premorbid academic functioning were also evaluated. The study also included 37 healthy controls. Neurocognitive subgroups were investigated using latent class analysis (LCA). The optimal number of clusters were determined based on Bayesian information criterion. Logistic regression analysis were conducted to investigate the predictors of the membership to globally impaired subgroup. RESULTS: LCA revealed two neurocognitive clusters including generally impaired (n=89, 60.5 %) and near-normal cognitive functioning (n=58, 39.5 %) subgroups. The generally impaired subgroup significantly underperformed both groups in memory, executive functions, processing speed, attention and both aspects of ToM. The near-normal cognitive functioning subgroup did not significantly underperformed healthy controls except RMET (p=0.01). The generally impaired subgroup had a history of increased number of developmental abnormalities (p=0.03) and more severe disorganised speech (p=0.02) compared to the near-normal cognitive functioning group. The near-normal subgroup had a significantly higher percentage of individuals with a history of good academic performance in childhood than the globally impaired group (p=0.002). Compared to the near-normal subgroup, the globally impaired subgroup was significantly older (p<0.001) and had mothers who were less educated (p=0.02). While relatively higher percentage of patients with bipolar disorder than schizophrenia were members of the near-normal functioning subgroup (and opposite for the generally impaired subgroup), the between-group difference was not significant. Logistic regression analysis suggested that both the number of neurodevelopmental abnormalities (p=0.02) and disorganised speech (p=0.05) were significant predictors of being included in the globally cognitive impaired subgroup (Log likelihood=144. 4, R2=0.23, p=0.003, percentage correctly identified as globally impaired 81.1 %). DISCUSSION: History of developmental abnormalities and persistent disorganisation rather than diagnosis are the significant predictors of the subgroup of individuals with global cognitive impairment in schizophrenia-bipolar disorder continuum. Studies investigating neurobiological and genetic underpinnings of the relationship between cognitive impairment, neurodevelopmental abnormalities and persistent disorganised speech might be important to develop a more valid classification of disorders presenting with psychotic and mood symptoms.
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spelling pubmed-72342212020-05-23 S63. CLINICAL AND DEVELOPMENTAL CHARACTERISTICS OF COGNITIVE SUBGROUPS IN A TRANSDIAGNOSTIC SAMPLE OF SCHIZOPHRENIA, SCHIZOAFFECTIVE DISORDER AND BIPOLAR DISORDER Bora, Emre Verim, Burcu Akgul, Ozge Ildız, Ayşegül Alptekin, Köksal Özerdem, Ayşegül Akdede, Berna Binnur Schizophr Bull Poster Session I BACKGROUND: Evidence suggests that neurocognitive dysfunction is a transdiagnostic feature of individuals across continuum between schizophrenia and bipolar disorder. However, there is a significant heterogeneity of neuropsychological and social cognitive abilities in schizophrenia, schizoaffective disorder and bipolar disorder. In recent years, several studies have investigated cognitive subgroups in schizophrenia-bipolar disorder continuum using data-driven methods and found that bipolar disorder includes several subgroups including a severely impaired and a neurocognitively intact clusters. However, neurodevelopmental and clinical characteristics of cognitive subgroups are not clear. METHODS: 147 clinically stable patients with schizophrenia, schizoaffective or bipolar disorder were assessed using clinical rating scales for current psychotic and affective symptoms, schizobipolar scale, and a comprehensive neuropsychological battery including measures of ToM (Hinting and Reading the mind from the Eyes (RMET) task)). Developmental history and premorbid academic functioning were also evaluated. The study also included 37 healthy controls. Neurocognitive subgroups were investigated using latent class analysis (LCA). The optimal number of clusters were determined based on Bayesian information criterion. Logistic regression analysis were conducted to investigate the predictors of the membership to globally impaired subgroup. RESULTS: LCA revealed two neurocognitive clusters including generally impaired (n=89, 60.5 %) and near-normal cognitive functioning (n=58, 39.5 %) subgroups. The generally impaired subgroup significantly underperformed both groups in memory, executive functions, processing speed, attention and both aspects of ToM. The near-normal cognitive functioning subgroup did not significantly underperformed healthy controls except RMET (p=0.01). The generally impaired subgroup had a history of increased number of developmental abnormalities (p=0.03) and more severe disorganised speech (p=0.02) compared to the near-normal cognitive functioning group. The near-normal subgroup had a significantly higher percentage of individuals with a history of good academic performance in childhood than the globally impaired group (p=0.002). Compared to the near-normal subgroup, the globally impaired subgroup was significantly older (p<0.001) and had mothers who were less educated (p=0.02). While relatively higher percentage of patients with bipolar disorder than schizophrenia were members of the near-normal functioning subgroup (and opposite for the generally impaired subgroup), the between-group difference was not significant. Logistic regression analysis suggested that both the number of neurodevelopmental abnormalities (p=0.02) and disorganised speech (p=0.05) were significant predictors of being included in the globally cognitive impaired subgroup (Log likelihood=144. 4, R2=0.23, p=0.003, percentage correctly identified as globally impaired 81.1 %). DISCUSSION: History of developmental abnormalities and persistent disorganisation rather than diagnosis are the significant predictors of the subgroup of individuals with global cognitive impairment in schizophrenia-bipolar disorder continuum. Studies investigating neurobiological and genetic underpinnings of the relationship between cognitive impairment, neurodevelopmental abnormalities and persistent disorganised speech might be important to develop a more valid classification of disorders presenting with psychotic and mood symptoms. Oxford University Press 2020-05 2020-05-18 /pmc/articles/PMC7234221/ http://dx.doi.org/10.1093/schbul/sbaa031.129 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Session I
Bora, Emre
Verim, Burcu
Akgul, Ozge
Ildız, Ayşegül
Alptekin, Köksal
Özerdem, Ayşegül
Akdede, Berna Binnur
S63. CLINICAL AND DEVELOPMENTAL CHARACTERISTICS OF COGNITIVE SUBGROUPS IN A TRANSDIAGNOSTIC SAMPLE OF SCHIZOPHRENIA, SCHIZOAFFECTIVE DISORDER AND BIPOLAR DISORDER
title S63. CLINICAL AND DEVELOPMENTAL CHARACTERISTICS OF COGNITIVE SUBGROUPS IN A TRANSDIAGNOSTIC SAMPLE OF SCHIZOPHRENIA, SCHIZOAFFECTIVE DISORDER AND BIPOLAR DISORDER
title_full S63. CLINICAL AND DEVELOPMENTAL CHARACTERISTICS OF COGNITIVE SUBGROUPS IN A TRANSDIAGNOSTIC SAMPLE OF SCHIZOPHRENIA, SCHIZOAFFECTIVE DISORDER AND BIPOLAR DISORDER
title_fullStr S63. CLINICAL AND DEVELOPMENTAL CHARACTERISTICS OF COGNITIVE SUBGROUPS IN A TRANSDIAGNOSTIC SAMPLE OF SCHIZOPHRENIA, SCHIZOAFFECTIVE DISORDER AND BIPOLAR DISORDER
title_full_unstemmed S63. CLINICAL AND DEVELOPMENTAL CHARACTERISTICS OF COGNITIVE SUBGROUPS IN A TRANSDIAGNOSTIC SAMPLE OF SCHIZOPHRENIA, SCHIZOAFFECTIVE DISORDER AND BIPOLAR DISORDER
title_short S63. CLINICAL AND DEVELOPMENTAL CHARACTERISTICS OF COGNITIVE SUBGROUPS IN A TRANSDIAGNOSTIC SAMPLE OF SCHIZOPHRENIA, SCHIZOAFFECTIVE DISORDER AND BIPOLAR DISORDER
title_sort s63. clinical and developmental characteristics of cognitive subgroups in a transdiagnostic sample of schizophrenia, schizoaffective disorder and bipolar disorder
topic Poster Session I
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234221/
http://dx.doi.org/10.1093/schbul/sbaa031.129
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