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Area of Science:

  • Neuroscience
  • Psychiatry
  • Cognitive Science

Background:

  • Cognitive functioning is impaired in individuals with psychosis.
  • Various factors including age, sex, education, and childhood adversity are associated with cognitive function.
  • Cognitive deficits in psychosis may stem from general risk factors for poor cognition.

Purpose of the Study:

  • To quantify the extent to which cognitive impairments in psychosis are attributable to exposures to general risk factors.
  • To differentiate the impact of diagnostic classification versus other exposures on cognitive function.

Main Methods:

  • A cross-sectional study utilizing data from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) studies.
  • Predictive modeling with extreme gradient boosting regression and Shapley additive explanations (SHAP) values to analyze relationships.
  • Inclusion of healthy controls, patients with schizophrenia, schizoaffective disorder, bipolar I disorder with psychosis, and their relatives.

Main Results:

  • The predictive model accurately captured cognitive composite scores (r=0.72).
  • Individuals with schizophrenia, schizoaffective disorder, and bipolar I disorder with psychosis exhibited significantly poorer cognitive scores than controls.
  • Transdiagnostic factors, rather than diagnosis alone, accounted for a substantial portion of cognitive impairment, with antipsychotic dose also contributing.

Conclusions:

  • A significant proportion of cognitive impairment in psychosis is linked to factors relevant to the general population.
  • Interventions for cognitive deficits in psychosis may benefit from a diagnosis-agnostic, symptom-targeted approach.
  • Understanding and addressing transdiagnostic risk factors is crucial for managing cognitive dysfunction in psychotic disorders.