The course of neuropsychological functioning in young people with attenuated versus discrete mental disorders

A M Tickell; R S C Lee; I B Hickie; Daniel F Hermens

doi:10.1111/eip.12499

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The course of neuropsychological functioning in young people with attenuated versus discrete mental disorders

Journal article

Peer reviewed

The course of neuropsychological functioning in young people with attenuated versus discrete mental disorders

A M Tickell, R S C Lee, I B Hickie and Daniel F Hermens

Early Intervention in Psychiatry, Vol.13(3), pp.425-433

2019

DOI: https://doi.org/10.1111/eip.12499

Appears in Thompson Institute Research Collection

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Abstract

Clinical Sciences

Psychology

clinical staging

longitudinal study

neuropsychology

young people

youth mental health

Other Collaborations

Thompson Institute Special Collection

AIM: Clinical staging of mental disorders is designed to facilitate the selection of stage-appropriate interventions, early in the course of illness. Neuropsychological performance, particularly at early stages of mental disorder, is a strong predictor of medium-term functional outcomes. Despite this, the longitudinal examination of neuropsychological profiles in early stages of illness is poorly researched. Thus, we examined baseline and longitudinal neuropsychological profiles of young patients with attenuated syndromes vs those with discrete disorders. METHODS: Neuropsychological testing of 497 help-seeking young people (21.2±3 years; 56% female). Clinical staging, assigned separately from testing, rated 262 individuals as "attenuated syndrome" (stage 1b) and 235 as "discrete" or "persistent" disorder (stage 2+). Follow-up testing was undertaken in 170 individuals (54% at stage 1b) after 19.8±9 months (range: 3 to 51 months). RESULTS: At baseline, attenuated and discrete/persistent disorders significantly differed in 4 of the 9 neuropsychological measures (verbal learning, verbal memory, visual memory and set shifting). Despite this, both groups showed similar improvement in neuropsychological functioning at follow-up, particularly in processing speed, sustained attention and visual memory. Longitudinal improvement in cognition corresponded with increases in socio-occupational functioning. DISCUSSION: The degree of baseline neuropsychological dysfunction discriminates those with attenuated syndromes from those with a discrete/persistent disorder. Furthermore, improvement in neuropsychological functioning corresponded with improvement in clinical and functional status, despite stage of illness. This suggests that neuropsychological functioning remains relatively stable in young people with a mental illness and may be a critical window for intervention.

Details

Title: The course of neuropsychological functioning in young people with attenuated versus discrete mental disorders
Authors: A M Tickell (Corresponding Author) - The University of Sydney
R S C Lee (Author) - The University of Sydney
I B Hickie (Author) - The University of Sydney
Daniel F Hermens (Author) - The University of Sydney
Publication details: Early Intervention in Psychiatry, Vol.13(3), pp.425-433
Publisher: Wiley-Blackwell Publishing Asia
Date published: 2019
DOI: 10.1111/eip.12499
ISSN: 1751-7885
Organisation Unit: University of the Sunshine Coast, Queensland; Thompson Institute
Language: English
Record Identifier: 99450864602621
Output Type: Journal article

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