MedicalResearch.com Interview with:
Richard Keefe PhD
Professor in Psychiatry and Behavioral Sciences
Duke Institute for Brains Sciences
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A lot of studies have shown that cognitive deficits are present in young people at risk for psychosis. There have been calls for investigations of the idea that cognition declines over time in the young people who are at highest risk, but longitudinal studies are hard to conduct so not much work has been done to address this question.
The main finding from our study is that the cognitive architecture – the way the various aspects of cognitive functioning appear to be organized in each individual’s brain based upon their pattern of performance – changes over time in those young people who are in the midst of developing psychosis. Interestingly, cognitive architecture also becomes more disorganized in those whose high-risk symptoms do not remit over a two year period, and is related to the functional difficulties they may be having. The young people whose high risk symptoms were present at the beginning of the study but remitted later actually improved cognitively over the two year period of the study.
MedicalResearch.com: What should readers take away from your report?
Response: Patterns of cognitive functioning over time in those young people who are at risk for psychosis may help us understand who is likely to develop full blown psychosis and who is likely to remit from the high risk state. These patterns are also related to how well the young person is expected to function in their everyday lives.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: These data were collected in Singapore, which is a very structured society with very little substance abuse due to the strict laws against it. These findings should be confirmed in other cultures and nations with more liberal social policies, as the role of drug use is not known. The relationship between these patterns and underlying brain changes is also not known but should continue to be investigated.
Lam M, Lee J, Rapisarda A, et al. Longitudinal Cognitive Changes in Young Individuals at Ultrahigh Risk for Psychosis. JAMA Psychiatry. Published online July 25, 2018. doi:10.1001/jamapsychiatry.2018.1668
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