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Premorbid IQ in Schizophrenia: A Meta-Analytic Review

Published on May 1, 2008in American Journal of Psychiatry13.655
· DOI :10.1176/appi.ajp.2008.07081242
Kristen A. Woodberry16
Estimated H-index: 16
,
Anthony J. Giuliano15
Estimated H-index: 15
,
Larry J. Seidman109
Estimated H-index: 109
Abstract
Objective: Over the past three decades, there have been significant changes in the diagnostic criteria for schizophrenia as well as changes in measurement of IQ. The last quantitative review of the literature on premorbid IQ in schizophrenia was published more than two decades ago. Since that time, there have been many published studies of data sets pertaining to this issue. The purpose of the present review was to provide an updated meta-analysis of premorbid IQ in individuals who later develop schizophrenia. Method: The authors performed a systematic literature search, which yielded 18 studies that met criteria for the meta-analysis. Inclusion criteria were 1) premorbid psychometric measures of IQ in subjects who were later diagnosed with schizophrenia, schizoaffective disorder, or schizophreniform disorder, 2) similar comparison data, and 3) sufficient data for calculation of an effect size. The analogue to the analysis of variance method was used to model between-study variance due to key study-design...
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  • Citations (374)
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References38
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#1Todd Lencz (Albert Einstein College of Medicine)H-Index: 68
#2Christopher W. Smith (North Shore-LIJ Health System)H-Index: 15
Last. Barbara A. Cornblatt (Albert Einstein College of Medicine)H-Index: 38
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Background Neurocognitive deficits are considered to be central to the pathophysiology of schizophrenia, and the neurodevelopmental model suggests that such deficits precede full-blown psychosis. The present study examined performance on a broad neuropsychological battery of young subjects considered to be at clinical high risk for schizophrenia, who were subsequently followed to determine clinical outcome. Methods Subjects were 38 clinical high-risk patients (58% male patients; mean age=16.5) a...
334 CitationsSource
#1Marie-Claire Whyte (Edin.: University of Edinburgh)H-Index: 5
#2Caroline E. Brett (Edin.: University of Edinburgh)H-Index: 15
Last. Eve C. Johnstone (Edin.: University of Edinburgh)H-Index: 57
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Background Neuropsychological assessments of relatives of schizophrenics have shown subtle impairments in verbal memory, executive and intellectual function, which are stable in those beyond the age of maximum risk for the disorder. We sought to: (1) determine baseline neurocognitive predictors of psychosis, and (2) compare performance over time between relatives within the age of maximum risk, and controls. Methods (1) and (2) were examined in 118 individuals at familial high risk of schizophre...
63 CitationsSource
#1William S. Kremen (UCSD: University of California, San Diego)H-Index: 53
#2Michael J. Lyons (BU: Boston University)H-Index: 68
Last. Ming T. Tsuang (UCSD: University of California, San Diego)H-Index: 123
view all 10 authors...
Twin studies are advantageous because sources of genetic and environmental variation are equated in ways that are not possible in standard case-control designs. We examined premorbid cognitive ability by comparing Armed Forces Qualification Test scores administered at the time of military enlistment in 21 schizophrenia-discordant twin pairs and 860 matched control twins. Scores were significantly lower in schizophrenia probands than in their nonpsychotic co-twins; co-twins were midway between pr...
23 CitationsSource
#1Larry J. Seidman (Massachusetts Mental Health Center)H-Index: 109
#2Stephen L. Buka (Harvard University)H-Index: 64
Last. Ming T. Tsuang (UCSD: University of California, San Diego)H-Index: 123
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It is well established that IQ is lower among persons with schizophrenia than in the general population. However, it remains unclear if there is deterioration beyond a premorbid deficit. In order to assess the question of IQ deterioration, we assessed persons pre- and-post psychosis, comparing those who developed schizophrenia with those who did not. Twenty six patients with schizophrenia and 59 normal controls, evaluated at age 7 in the prospective, longitudinal, National Collaborative Perinata...
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#2Mark Weiser (Sheba Medical Center)H-Index: 36
Last. Michael Davidson (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 111
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Context Consistent evidence indicates that some, but not most, patients with schizophrenia have below-average intelligence years before they manifest psychosis. However, it is not clear whether this below-average premorbid intelligence is stable or progressive. Objective To examine whether increased risk for schizophrenia is associated with declining intellectual performance from childhood through adolescence. Design Historical cohort study of an entire population using record linkage for psychi...
128 CitationsSource
#1Holger J. Sørensen (Copenhagen University Hospital)H-Index: 24
#2Erik Lykke Mortensen (UCPH: University of Copenhagen)H-Index: 58
Last. Sarnoff A. Mednick (SC: University of Southern California)H-Index: 68
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A prospective study based on the U.S. National Collaborative Perinatal Project and using the Wechsler Intelligence Scale for Children (WISC) found lower test scores for the Coding subtest in preschizophrenic children than in their unaffected siblings. Using data on cognitive functioning in adolescence, the aim of the present prospective study was to examine whether low scores on Coding is associated with the risk of developing schizophrenia spectrum disorders. The 12 subtests of the WISC were ad...
37 CitationsSource
OBJECTIVE: While cognitive deficits are frequently reported in psychotic disorders, it is unclear whether these impairments predate the onset of illness and to what extent they are predictive of later transition to psychosis. METHOD: The authors studied 37 healthy volunteers and 98 symptomatic, help-seeking patients meeting the inclusion criteria of a treatment program for people at ultra-high risk for psychosis. Of the ultra-high-risk patients, 34 (34.7%) developed psychosis over the course of ...
317 CitationsSource
#1Stanley Zammit (UoB: University of Bristol)H-Index: 48
#2Peter AllebeckH-Index: 61
Last. Glyn Lewis (UoB: University of Bristol)H-Index: 94
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Context Longitudinal studies indicate that a lower IQ score increases risk of schizophrenia. Preliminary evidence suggests there is no such effect for nonpsychotic bipolar disorder. To our knowledge, there are no prior population-based, longitudinal studies of premorbid IQ score and risk of developing severe depression requiring hospital admission. Objectives To investigate the association between premorbid IQ score and risk of developing schizophrenia, other nonaffective psychoses, bipolar diso...
335 CitationsSource
#1Asaf Caspi (Sheba Medical Center)H-Index: 13
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Abstract Background : The purpose of this historical prospective study was to follow the cognitive impairment in schizophrenia from the premorbid period until shortly after the onset of the first psychotic episode within the same subjects. Methods : Forty-four first episode schizophrenia patients were enrolled in the study. Their cognitive performance was assessed as part of the Israeli Draft Board aptitude assessments at ages 16–17, when all were found to be in good mental health (first assessm...
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Cited By374
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Abstract Background Schizophrenia risk is associated with both genetic and environmental risk factors. Furthermore, cognitive abnormalities are established core characteristics of schizophrenia. We aim to assess whether a classification approach encompassing risk factors, cognition and their associations can discriminate patients (SCZ) from healthy controls (HC). We hypothesized that cognition would demonstrate greater HC-SCZ classification accuracy, and that combined gene-environment stratifica...
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Schizophrenia has long been thought to have origins in early brain development, though studies of fetal and early childhood brain development have been rare. Recently, imaging studies in this critical period of risk for schizophrenia have begun to delineate the normal developmental trajectories of brain structure and function. Studies to date indicate that the fundamental structural and functional architecture of the human brain is well established by the first year or two of life, and genetic a...
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Neurocognitive deficits are associated with impaired global functioning and psychotic symptoms. However, whether symptoms can mediate the relationship between neurocognition and global functioning in adolescent psychosis is unclear. Here, we investigated if symptoms assessed with the Positive And Negative Syndrome Scale (PANSS), mediated the relationship between neurocognitive performance and global functioning in adolescents with non-affective early-onset psychotic disorders (EOP). Sixty-one ad...
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