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Volume 49, Issue 1, Pages 52-60 (January 2010)


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Neurocognition in Early-Onset Schizophrenia and Schizoaffective Disorders

Stephen R. Hooper, Ph.D.aCorresponding Author Informationemail address, Anthony J. Giuliano, Ph.D.b, Eric A. Youngstrom, Ph.D.a, David Breiger, Ph.D.c, Linmarie Sikich, M.D.a, Jean A. Frazier, M.D.b, Robert L. Findling, M.D.d, Jon McClellan, M.D.c, Robert M. Hamer, Ph.D.a, Benedetto Vitiello, M.D.e, Jeffrey A. Lieberman, M.D.f

Accepted 21 September 2009.

Objective

We examined the neuropsychological functioning of youth enrolled in the NIMH funded trial, Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS). We compared the baseline neuropsychological functioning of youth with schizophrenia (SZ, n = 79) to those with schizoaffective disorder (SA, n = 40), and examined the relationship of different variables of illness severity and adaptive behavior to neuropsychological functioning.

Method

Participants ranged in age from 8 to 19 years. Diagnostic status was confirmed via structured interview over multiple time points. Domains of neuropsychological functioning included fine-motor, attention, working memory, problem-solving efficiency, inhibitory control, and social cognition. Other variables included intelligence (IQ), academic achievement skills, adaptive behavior, and different measures of illness severity.

Results

The two groups did not differ on IQ or on any of the neuropsychological domains. The SZ group performed significantly lower in spelling. A high proportion of individuals in both groups reflected significant intellectual and academic achievement skill deficits. Significant correlations were found between the neurocognitive domains and both illness severity and adaptive behavior variables.

Conclusions

There were few differences between the SZ and SA groups on IQ, achievement, or neuropsychological functioning; however, both groups showed significantly high rates of deficits in IQ and basic academic skills. Correlations of the neurocognitive functions with illness severity and adaptive behavior were small to moderate in magnitude. These findings continue to implicate the importance of neurocognitive functioning as a key area of vulnerability in the study of youth with schizophrenia spectrum disorders.

a University of North Carolina

b Cambridge Health Alliance, Harvard Medical School

c University of Washington

d Case Western Reserve University

e National Institutes of Mental Health

f Columbia University and New York State Psychiatric Institute

Corresponding Author InformationCorrespondence to Dr. Stephen R. Hooper, Center for Development and Learning, CB# 7255, The Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7255

 The Treatment of Early Onset Schizophrenia Spectrum (TEOSS) project was conducted with grant support from the National Institute of Mental Health under cooperative agreements U01MH61528 to the University of North Carolina (P.I.: Lin Sikich), U01MH61464 to the University of Washington (P.I.: Jon McClellan), U01MH62726 to Harvard Medical School (P.I.: Jean Frazier), and U01MH61355 to Case Western Reserve University (P.I.: Robert Findling), and by the Maternal Child Health Bureau (#MCJ379154A), and the Administration on Developmental Disabilities (#90DD043003). The research was conducted in NIH supported Clinical Research Centers at Seattle Children's Hospital, University of Washington (M01-RR-00037) and the University of North Carolina (M01-RR00046).

 The opinions and assertions contained in this report are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Health and Human Services, the National Institutes of Health, or the National Institute of Mental Health.

 Disclosure: Dr. Hooper receives or has received research support or served as a speaker/consultant for Eli Lilly and Sanofi-Aventis. Dr. Youngstrom has previously served on the Data Safety and Monitoring Board for Eli Lilly and consulted in the past with Otsuka. Dr. Sikich has a current financial interest and receives research funding or participates in clinical trials with Janssen, Pfizer, Bristol Myers-Squibb, Neuropharm, Curemark, and Seaside Pharmaceuticals. She also received software for a computer intervention in schizophrenia from Posit Science. In the past, Dr. Sikich received research funding from Eli Lilly, Janssen, Pfizer, Otsuka, and Astra Zeneca, and has served as a consultant for Sanofi Aventis and ABT Associates. Dr. Frazier receives or has received research support and acted as a consultant for Bristol-Myers Squibb Company, Eli Lilly, GlaxoSmithKline, Johnson & Johnson, Neuropharm, Otsuka America Pharmaceutical, and Pfizer. Dr. Findling receives or has received research support, acted as a consultant, and/or served on a speaker's bureau for Abbott, Addrenex, AstraZeneca, Biovail, Bristol-Myers Squibb, Forest, GlaxoSmithKline, Johnson & Johnson, KemPharm, Eli Lilly, Lundbeck, Neuropharm, Novartis, Organon, Otsuka, Pfizer, Sanofi-Aventis, Sepracore, Shire, Solvay, Supernus Pharmaceuticals, Validus, and Wyeth. Dr. McClellan has had past research support from Pfizer. Dr. Hamer has served as a consultant or advisor for Acadia, Cenerx, Corcept, Epix, Johnson & Johnson, NeuroPharmaBoost, Pepper-Hamilton, PureTechVentures, Sanofi-Aventis, and Takeda. He has served on the advisory board for Enabled MD, Novartis, and Wyeth. He has served on a Data Safety Monitoring Board (DSMB) for Allergan, Eli Lilly & Company, Pfizer, Schwartz, and Solvey. He has served on a Mock Advisory Panel for Alpharma. He has served as a statistician on a University of North Carolina contract for a clinical trial with AstraZeneca. He has taught several seminars for SAS Institute. He has served as an expert witness for Winston-Strawn. He or his wife own stock in Bristol-Myers Squibb, Amgen, Eli Lilly & Company, Genentech, Proctor & Gamble, and Sepracor. Dr. Lieberman serves as a consultant and/or advisor for Astra Zeneca, Bioline, Eli Lilly, Forest Laboratories, GlaxoSmithKline, Pfizer, and Wyeth; and as a member of the Data Safety Monitoring Board (DSMB) for Solvay. He does not receive financial compensation or salary support for this participation as a consultant or as a member of a board. He receives grant support from AstraZeneca, Allon, Bristol-Myers Squibb, Cephalon, GlaxoSmithKline, Janssen, Merck, Pfizer, and Wyeth; and he holds a patent from Repligen. Drs. Guiliano, Breiger, and Vitiello report no biomedical financial interests or potential conflicts of interest.

PII: S0890-8567(09)00013-6

doi:10.1016/j.jaac.2009.11.001


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