Cognitive deficits in clinical high risk, genetically at high-risk for psychosis and patients with first-episode schizophrenia

Abstract Background: Cognitive deficits are core characteristics of schizophrenia, which precedes the emergence of psychotic symptoms. Clinical high risk for psychosis (CHR) individuals and genetically high-risk of psychosis (GHR) individuals also exhibit cognitive impairments, but it is not clear which domains of cognitive impairments in these two groups were more similar to those of schizophrenia patients. Moreover, it is not clear whether quality factors contribute to this impairment or the disease state causes it. This study aims to explore the cognitive impairments profiles in CHR, GHR and patients with first episode schizophrenia (FES). Method: We compared the cognitive functions of three groups and a healthy control group (HCs) using the MATRICS Consensus Cognitive Battery (MCCB). Our sample consisted of 56 patients with FES, 42 individuals at CHR, 26 individuals at GHR, and 62 HCs. Results: Individuals with FES, GHR, and CHR showed significant impairment in most MCCB domains, with the exception of visual learning, when compared to the HCs. None of the MCCB domains were able to accurately distinguish between CHR and GHR individuals. GHR and CHR individuals had intermediate scores between FES and HCs on the domain of processing speed and attention. However, the impairment levels in working memory and verbal learning were similar across all three groups. The CHR performance in social cognition was comparable to that of the HCs, whereas there was no significant difference in problem-solving scores between the GHR and HC groups. Conclusion: Our findings suggest that significant cognitive deficits exist in CHR, GHR, and FES individuals, and these deficits vary across domains. Cognitive impairment may be a key feature of individuals with schizophrenia, with processing speed and attention potentially serving as reliable markers for identifying those at risk for psychosis. The damage of reasoning/problem solving may be qualitative trait, while as social recgnition may be state characteristic of schizophrenia.