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It remains unclear whether the onset of psychosis is associated with deterioration in cognitive performance. The aim of this study was to examine the course of cognitive performance in an ultrahigh risk (UHR) cohort, and whether change in cognition is associated with transition to psychosis and change in functioning. Consecutive admissions to Personal Assessment and Crisis Evaluation (PACE) Clinic between May 1994 and July 2000 who had completed a comprehensive cognitive assessment at baseline and follow-up were eligible (N = 80). Follow-up ranged from 7.3 to 13.4 years (M = 10.4 years; SD = 1.5). In the whole sample, significant improvements were observed on the Similarities (P =.03), Information (P <.01), Digit Symbol Coding (P <.01), and Trail Making Test-B (P =.01) tasks, whereas performance on the Rey Auditory Verbal Learning Test (Trials 1–3) declined significantly (P <.01) over the follow-up period. Change in performance on cognitive measures was not significantly associated with transition status. Taking time to transition into account, those who transitioned after 1 year showed significant decline on Digit Symbol Coding, whereas those who did not transition improved on this measure (P =.01; effect size [ES] = 0.85). Small positive correlations were observed between improvements in functioning and improvements in performance on Digit Symbol Coding and Arithmetic (0.24, P =.03 and 0.28, P =.01, respectively). In summary, the onset of psychosis was not associated with deterioration in cognitive ability. However, specific findings suggest that immediate verbal learning and memory, and processing speed may be relevant domains for future risk models and early intervention research in UHR individuals. [ABSTRACT FROM AUTHOR]

Background: The prevalence of antibodies to Toxoplasma gondii, a ubiquitous parasitic protozoan causing the infectious disease toxoplasmosis, is increased in patients with psychotic disorders compared to the general population. We have previously shown that antibody titers for T.gondii correlate with the severity of positive symptoms in young people at ultrahigh risk (UHR) for psychosis, suggesting that infection with T. gondii may be relevant to the manifestation of psychosis. However, it is unclear if T. gondii antibodies represent a risk factor for psychosis onset or nonpsychotic outcome in UHR individuals. The aim of the present study was to examine whether seropositivity for T.gondii is associated with transition to psychosis and other outcomes in young people at UHR for psychosis. Methods: The study sample consisted of 96 individuals at UHR for psychosis who were referred to the Personal Assistance and Crisis Evaluation (PACE) clinic in Melbourne, Australia, between 2001 and 2004, consented to optional blood tests for infectious agents and were followed up for up to 10 years after baseline (median (interquartile range) duration of follow-up: 7.15 (3.14 – 7.72) years). Serum IgG antibodies to six viral and parasitic pathogens (Toxoplasma gondii, Herpes Simplex Virus Type 1 and 2, Cytomegalovirus, Epstein Barr Virus, Varicella- Zoster Virus) were measured at baseline. Outcome measures included transition to psychosis, general psychiatric symptomatology and positive psychotic symptoms (BPRS), negative symptoms (SANS), depressive symptoms (HAM-D), anxiety symptoms (HAM-A) and functioning (SOFAS and GAF). Cox proportional hazards regression and linear regression models were used to examine the associations of seropositivity and antibody titers at baseline and transition to psychosis and other outcomes at follow-up. Results: A total of 17 individuals (17.7%) were seropositive for Toxoplasma gondii at baseline. The rate of transition to psychosis was higher among seropositive (35.7%) compared to seronegative participants (14.6%), although this was not statistically significant (p=0.101). Antibody titers (IgG) for Toxoplasma gondii were significantly higher at baseline in participants who later transitioned to psychosis (1.34 ± 1.36 vs. 0.79 ± 0.73, p=0.027). Seropositivity for T.gondii IgG at baseline significantly predicted transition to psychosis within the follow-up duration (hazard ratio [HR]=3.61, 95%CI 1.08 – 12.00, p=0.036). Toxoplasma IgG at baseline were significantly associated with higher BPRS scores at follow-up in participants who were seropositive at baseline (Beta=6.38, 95%CI 0.43 – 12.34, p=0.038). No significant associations were found between antibodies to other pathogens and outcome, or between antibodies to Toxoplasma gondii and any other outcomes. Discussion: Our findings suggest that the presence of IgG class antibodies for Toxoplasma gondii is associated with a higher risk for psychosis transition in individuals at UHR for psychosis, but not with risk for other longterm outcomes. These observations provide support for the hypothesis that infection with Toxoplasma gondii may be an environmental risk factor for psychosis and suggest that IgG antibodies for Toxoplasma gondii in individuals at UHR for psychosis have prognostic relevance. [ABSTRACT FROM AUTHOR]

Background: Early childhood development is considered to be the most critical developmental phase throughout the lifespan. Cognitive and motor dysfunction are hallmark features found along the psychosis spectrum and have also been shown in young people who report subclinical psychotic experiences (PE). Whether such deficits can be detected in infancy is not yet known. The aim of the present research was to examine early childhood developmental skills and their association with PE in childhood and adolescence. Methods: Data was taken from the Western Australia Pregnancy Cohort (Raine) Study, a pregnancy cohort study in which 2,868 infants were enrolled. Early childhood development was measured at age 1, 2 and 3 using the Infant Monitoring Questionnaire (IMQ; now the Ages and Stages questionnaire. Outcome of interest: PE was measured at age 10 via parent-report, and at age 14 and 17 via self-report by the participants using the 2 items (‘hearing things’ and ‘seeing things’) from the Child Behaviour Checklist (CBCL)/Youth Self-Report (YSR) thought problems subscale. The PE group included any participant who endorsed either or both of the items at any of the 3 time-points. The PE group was further subdivided into those who endorsed transient PE (one time-point) or recurring PE (2 or more time-points). Random effects logistic regression models were performed to investigate the relationship between early childhood development and later risk. Developmental time specific investigations (at age 1, 2 and 3 years of age separately) were also conducted using logistic regressions. Cumulative risk based on category specific deficits at age 3 was also calculated. This analysis was also applied to compare the PE group vs. controls, the transient PE group vs. controls and the recurring PE group vs. controls. Results: In the first 3 years of life, lower scores in communication (adjusted OR = 1.32, 95% CI = 1.01–1.72, p = 0.05) and adaptive (problem-solving) (adjusted OR = 1.26, 95% CI = 1.01–1.59, p = 0.048) skills were found to be predictive of PE in childhood and/or adolescence. For the age specific analysis, adaptive skill deficits specifically at 1 year of age predicted PE (adjusted OR = 1.18, 95% CI = 1.03–1.35, p = 0.017), while at 2 years of age, deficits in communication (adjusted OR = 1.35, 95% CI = 1.18–1.54, p<0.001) and adaptive skills (adjusted OR = 1.25, 95% CI = 1.08–1.45, p<0.005) predicted PE. Importantly, at 3 years of age, deficits in any of the 5 categories (communication, gross motor, fine motor, adaptive and personal social) were predictive of PE. Deficits (lowest 10th percentile) in 1–2 categories at 3 years of age led to an almost a 2-fold increase risk of having a PE (adjusted OR = 1.94, 95% CI = 1.38–2.71, p < 0.001), while deficits in 3–5 categories led to a 3-fold increased risk of having a PE (adjusted OR = 3.02, 95% CI = 1.65–5.50, p = <0.001). When subdividing PE into those with transient and recurring PE, different patterns emerged, in which motor deficits in the first 3 years of life were more associated with the recurring PE group. Discussion: The present research suggests that lower scores in early childhood developmental skills in the first 3 years of life are strongly associated with childhood and adolescent PE. Results showed that deviances in communication and problem-solving abilities during the first 3 years of life are particularly associated. At age 3 specifically, deficits in all domains of development are predictive of PE, and the greater the number of category deficits, the greater the risk. Differing patterns of development emerge for the transient PE and recurring PE groups. The findings enlighten the understanding of the neurodevelopmental origins of early onset PE for a proportion of individuals. [ABSTRACT FROM AUTHOR]