Transdiagnostic neurocognitive subgroups and functional course in young people with emerging mental disorders: a cohort study

Jacob J Crouse; Kate M Chitty; Frank Iorfino; Joanne S Carpenter; Django White; Alissa Nichles; Natalia Zmicerevska; Ashleigh M Tickell; Rico S C Lee; Sharon L Naismith; Elizabeth M Scott; Jan Scott; Daniel F Hermens; Ian B Hickie

doi:10.1192/bjo.2020.12

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Transdiagnostic neurocognitive subgroups and functional course in young people with emerging mental disorders: a cohort study

Journal article

Open access

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Transdiagnostic neurocognitive subgroups and functional course in young people with emerging mental disorders: a cohort study

Jacob J Crouse, Kate M Chitty, Frank Iorfino, Joanne S Carpenter, Django White, Alissa Nichles, Natalia Zmicerevska, Ashleigh M Tickell, Rico S C Lee, Sharon L Naismith, …

BJ Psych Open, Vol.6(2), e31

2020

DOI: https://doi.org/10.1192/bjo.2020.12

Appears in Thompson Institute Research Collection

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Abstract

Clinical Sciences

Public Health and Health Services

social functioning

outcome studies

psychotic disorders

anxiety disorders

depressive disorders

Other Collaborations

Thompson Institute Special Collection

UniSC Diversity Area - Disability and Inclusion

Background: Neurocognitive impairments robustly predict functional outcome. However, heterogeneity in neurocognition is common within diagnostic groups, and data-driven analyses reveal homogeneous neurocognitive subgroups cutting across diagnostic boundaries. Aims: To determine whether data-driven neurocognitive subgroups of young people with emerging mental disorders are associated with 3-year functional course. Method: Model-based cluster analysis was applied to neurocognitive test scores across nine domains from 629 young people accessing mental health clinics. Cluster groups were compared on demographic, clinical and substance-use measures. Mixed-effects models explored associations between cluster-group membership and socio-occupational functioning (using the Social and Occupational Functioning Assessment Scale) over 3 years, adjusted for gender, premorbid IQ, level of education, depressive, positive, negative and manic symptoms, and diagnosis of a primary psychotic disorder. Results: Cluster analysis of neurocognitive test scores derived three subgroups described as 'normal range' (n = 243, 38.6%), 'intermediate impairment' (n = 252, 40.1%), and 'global impairment' (n = 134, 21.3%). The major mental disorder categories (depressive, anxiety, bipolar, psychotic and other) were represented in each neurocognitive subgroup. The global impairment subgroup had lower functioning for 3 years of follow-up; however, neither the global impairment (B = 0.26, 95% CI -0.67 to 1.20; P = 0.581) or intermediate impairment (B = 0.46, 95% CI -0.26 to 1.19; P = 0.211) subgroups differed from the normal range subgroup in their rate of change in functioning over time. Conclusions: Neurocognitive impairment may follow a continuum of severity across the major syndrome-based mental disorders, with data-driven neurocognitive subgroups predictive of functional course. Of note, the global impairment subgroup had longstanding functional impairment despite continuing engagement with clinical services.

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Title: Transdiagnostic neurocognitive subgroups and functional course in young people with emerging mental disorders: a cohort study
Authors: Jacob J Crouse (Corresponding Author) - University of Sydney
Kate M Chitty (Author) - University of Sydney
Frank Iorfino (Author) - University of Sydney
Joanne S Carpenter (Author) - University of Sydney
Django White (Author) - University of New South Wales
Alissa Nichles (Author) - University of Sydney
Natalia Zmicerevska (Author) - University of Sydney
Ashleigh M Tickell (Author) - University of Sydney
Rico S C Lee (Author) - Monash University
Sharon L Naismith (Author) - University of Sydney
Elizabeth M Scott (Author) - University of Notre Dame
Jan Scott (Author) - Newcastle University, United Kingdom
Daniel F Hermens (Author) - University of the Sunshine Coast - Thompson Institute
Ian B Hickie (Author) - University of Sydney
Publication details: BJ Psych Open, Vol.6(2), e31; 9
Publisher: Cambridge University Press
Date published: 2020
DOI: 10.1192/bjo.2020.12
ISSN: 2056-4724
Copyright note: Copyright © The Author(s) 2020. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Organisation Unit: University of the Sunshine Coast, Queensland; Thompson Institute
Language: English
Record Identifier: 99450848602621
Output Type: Journal article

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

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