Cognitive Functioning in Prodromal Psychosis: A Meta-analysis
Abstract
CONTEXT: A substantial proportion of people at clinical high risk (HR) of psychosis will develop a psychotic disorder over time. Cognitive deficits may predate the onset of psychosis and may be useful as markers of increased vulnerability to illness. OBJECTIVE: To quantitatively examine the cognitive functioning in subjects at HR in the literature to date. DATA SOURCES: Electronic databases were searched until January 2011. All studies reporting cognitive performance in HR subjects were retrieved. STUDY SELECTION: Nineteen studies met the inclusion criteria, comprising a total of 1188 HR subjects and 1029 controls. DATA EXTRACTION: Neurocognitive functioning and social cognition as well as demographic, clinical, and methodological variables were extracted from each publication or obtained directly from its authors. DATA SYNTHESIS: Subjects at HR were impaired relative to controls on tests of general intelligence, executive function, verbal and visual memory, verbal fluency, attention and working memory, and social cognition. Processing speed domain was also affected, although the difference was not statistically significant. Later transition to psychosis was associated with even more marked deficits in the verbal fluency and memory domains. The studies included reported relatively homogeneous findings. There was no publication bias and a sensitivity analysis confirmed the robustness of the core results. CONCLUSIONS: The HR state for psychosis is associated with significant and widespread impairments in neurocognitive functioning and social cognition. Subsequent transition to psychosis is particularly associated with deficits in verbal fluency and memory functioning.
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Recent evidence shows that positive symptoms are weaker predictors of transition to psychosis and poor functional outcome than subjective cognitive difficulties.
“and subjective cognitive difficulties 73,74”
From Clinical, socio‐demographic and psychological characteristics in individuals with persistent psychotic experiences with and without a “need for care” (2016) · cites this paper as [74]
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- Authors
- Fusar-Poli, P., Deste, G., Smieskova, R., Barlati, S., Yung, A. R., Howes, O., Stieglitz, R.-D., Vita, A., McGuire, P., & Borgwardt, S.
- Affiliations
- University of Brescia (IT)
- University of Basel (CH)
- University of Manchester (GB)
- ORCID
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2012-06-01
- Volume
- 69
- Issue
- 6
- Pages
- 562-71
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2149592078
- Cited by
- 691
- References
- 81
- Citations by year
- 2026: 23 · 2025: 28 · 2024: 43 · 2023: 36 · 2022: 53 · 2021: 48 · 2020: 47 · 2019: 44 · 2018: 56 · 2017: 45 · 2016: 74 · 2015: 48 · 2014: 68 · 2013: 51 · 2012: 27
- FWCI
- 44.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- prodromal psychosis, clinical high risk for psychosis, cognitive impairment, neurocognitive function, social cognition, executive function, verbal fluency, memory, processing speed, transition to psychosis, vulnerability indicators
- MeSH terms
- Cognition Disorders, Humans, Psychotic Disorders, Risk
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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