Parcellating cognitive heterogeneity in early psychosis-spectrum illnesses: A cluster analysis

Jacob J Crouse; Ahmed A Moustafa; Sophia E R Bogaty; Ian B Hickie; Daniel F Hermens

doi:10.1016/j.schres.2018.06.060

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Parcellating cognitive heterogeneity in early psychosis-spectrum illnesses: A cluster analysis

Journal article

Peer reviewed

Parcellating cognitive heterogeneity in early psychosis-spectrum illnesses: A cluster analysis

Jacob J Crouse, Ahmed A Moustafa, Sophia E R Bogaty, Ian B Hickie and Daniel F Hermens

Schizophrenia Research, Vol.202, pp.91-98

2018

DOI: https://doi.org/10.1016/j.schres.2018.06.060

Appears in Thompson Institute Research Collection

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Abstract

psychosis-spectrum

cluster analysis

substance use

neurocognition

psychosocial functioning

Other Collaborations

Thompson Institute Special Collection

Cognitive impairment is argued to represent a core feature of psychosis-spectrum illnesses. However, within-diagnosis heterogeneity is common, and risk factors for poor cognition remain to be examined after statistically accounting for heterogeneity. Accordingly, we used a data-driven technique (cluster analysis) to empirically-derive cognitive clusters across diagnoses and examined whether concurrent substance use or a history of a neurodevelopmental/behavioral disorder differed between clusters. Data from 135 young help-seekers (aged 12-30 years) with a psychosis-spectrum illness were retrospectively analyzed. Ward's hierarchical cluster analysis classified three cognitive clusters characterized by: (1) normal-range; (2) mixed; and (3) grossly-impaired performance. Despite mostly comparable clinical and demographic measures, cluster 1 had superior socio-occupational functioning and the highest estimated premorbid IQ, followed sequentially by clusters 2 and 3. Proportions of cannabis and amphetamine users did not differ significantly across clusters, nor did rates of patients with a neurodevelopmental/behavioral disorder history. Cluster 3 was however comprised of fewer 'risky' drinkers, possibly reflecting reduced opportunity for social drinking associated with cognitive impairment. Estimated premorbid IQ predicted cluster membership (2 vs. 1 & 3 vs. 1), as did clinician-rated socio-occupational functioning and 'not being enrolled in school or tertiary education' (3 vs. 1). Our results suggest that concurrent substance use and history of a neurodevelopmental/behavioral disorder do not adequately explain cluster-level cognitive variance in this sample. Future work should integrate neurobiological measures associated with cognition (e.g. white matter integrity) to discern whether clusters reflect neurobiological subtypes better representative of pathophysiology than present symptom-based classifications. © 2018 Elsevier B.V.

Details

Title: Parcellating cognitive heterogeneity in early psychosis-spectrum illnesses: A cluster analysis
Authors: Jacob J Crouse (Corresponding Author) - University of Sydney
Ahmed A Moustafa (Author) - Western Sydney University
Sophia E R Bogaty (Author) - University of Sydney
Ian B Hickie (Author) - University of Sydney
Daniel F Hermens (Author) - University of the Sunshine Coast - Thompson Institute
Publication details: Schizophrenia Research, Vol.202, pp.91-98
Publisher: Elsevier BV
Date published: 2018
DOI: 10.1016/j.schres.2018.06.060
ISSN: 0920-9964; 1573-2509
Organisation Unit: University of the Sunshine Coast, Queensland; Thompson Institute
Language: English
Record Identifier: 99450878302621
Output Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Web Of Science research areas: Psychiatry

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