Original article

Korean Journal of Schizophrenia Research 2008;11(1):31-38.

정신분열병 초고위험군(Ultra High-Risk) 환자의 신경심리학적 이상 소견

Young-Chul Chung, MD1,2, Shi-Ha Shim, MD2, Mu-Sung Lim, MD2, Chun-Rong Li, MD1, Guang-Biao Huang, MD1, Keum-Hwa Yang2, Tae-Won Park, MD1,2, Jong-Chul Yang, MD1,2, Sang-Keun Chung, MD1,2 and Ik-Keun Hwang, MD1,2

Abstract

Objectives:Cognitive impairments are a core feature of Schizophrenia. One way of investigating the theory that cognitive deficits are present prior to the onset of psychosis is to evaluate cognitive functions of the subjects who are at high risk for transition to schizophrenia: a) offsprings of schizophrenic patients, genetic high-risk group and b) subjects at high risk clinical state for transition to schizophrenia, clinical high-risk group or ultra-high risk (UHR) group. We investigated clinical characteristics and neuropsychological abnormalities of the subject at UHR for schizophrenia.
Methods:Using CAARMS (Comprehensive assessment of at risk mental states) criteria, 16 subjects at UHR for schizophrenia were enrolled. As for clinical characteristics, DSM-IV diagnosis, PANSS (Positive and Negative Syndrome Scale), SANS (Scale for the Assesment of Negative Syptoms), HRSD (Hamilton Rating Scale For Depression), HRSA (Hamilton Rating Scale For Anxiety) were evaluated. The Digit span test, Auditory continuous performance test, Stroop test, Verbal learning test, Trail making test B, Wisconsin card sorting test, Finger tapping test and Verbal fluency test were performed to measure neuropsychological abnormalities.
Results:The PANSS, SANS, HRSD and HRSA scores were 64.88 (SD=13.33), 42.50 (SD=15.81), 11.73 (SD=6.53) and 13.75 (SD=9.19). The most common DSM-IV diagnoses were adjustment disorder, dysthymia, psychotic disorder NOS, etc. They performed poorly on most of neuropsychological tests, compared to normal controls. Especially, greater deficits were noted in the domains of attention and language. In addition, there were significant correlations between verbal fluency test and PANSS, SANS or HRSD scores.
Conclusion:These results indicate that significant neuropsychological abnormalities do exist in subjects at UHR for schizophrenia. Further study investigating whether these cognitive abnormalities predict transition to psychosis is warranted. (Korean J Schizophr Res 2008;11:31-38)

Key Words: Ultra High Risk,Neuropsychological abnormalities,Schizophrenia