November 15, 2006

Decrease in Attention and Processing Speed May Help Recognize Those At-Risk For Psychosis

Perhaps performance on tests of neurocognition - specifically, measures of vigilance (attention) and processing speed - should be added to the arsenal identifying "at-risk" individuals with a likelihood of developing a psychotic disorder within a year.

At-risk subjects who progressed to psychosis scored significantly lower in vigilance and processing speed than those at-risk who did not progress to psychosis. The scores of those at-risk who did not progress to psychosis were not significantly different from controls.

Poor performance on these tests of neurocognition may prove to be an early risk-predictor for subsequent development of psychotic disorders in at-risk individuals. These tests may help to define those in a true "prodrome" stage of a psychotic illness.

Note: "Prodrome" refers to the early symptoms of an illness which precede the fully developed disorder. The current dilemma involved in identification is that symptoms easily recognizable as "prodromal" to schizophrenia such as perceptual distortions, short transient hallucinations or mild paranoia, common in schizophrenia, also occur in the general population of people who do NOT go on to develop a psychotic illness. Thus, although "at-risk" can be determined in advance of the illness, "prodrome" tends to be determined retroactively - after actual on-set of the illness. For more information on "At-Risk", see: Risk in "at-risk" research


Original Source: A longitudinal study of neurocognitive function in individuals at-risk for psychosis
Schizophrenia Research Volume 88 (December 2006) Keefea, Perkinsb, Gub, Zipurskyc, Christensenc, Liebermand


Additional Reading on Neurocognition and Early Detection of Schizophrenia:
Special IQ Test for Schizophrenia
Young Adults at Schizophrenia Risk show Brain Activation Changes
Brain test assoc. with function


Comments

Hi. Actually back in the late 80's I read a book that said that the people who do badly on the "coding" subtest of the WISC / WAIS (Weschler) frequently went on to have mental problems. I took that test back then, did badly on the "coding" section, and fervently hoped that they were wrong about that. However, in the following decade I came down with Schizophrenia.

The test has a person see how quickly they can translate a bunch of numbers and/or letters (I don't remember exactly any more) into some funny looking symbols that they have made up. I enjoyed the test, thought I did well, but did very badly on the speed aspect, although well on the accuracy.

Posted by: Me at November 15, 2006 07:56 PM

"Me" - You have a point. Now that I think about it - my daughter, and many of our kids, were mis-diagnosed with ADD (inattentive type) before the psychotic disorder... and I remember my daughter being tested to an LD and being told she didn't qualify because she could do things - it would just take her so SO much LONGER than "normal".

I'm glad you commented.

-Naomi

Posted by: Naomi_njw at November 16, 2006 10:14 AM

It is actually quite common for a young person to get diagnosed with attention deficit disorder before they are diagnosed with schizophrenia as an adult.

One of the most obvious features of childhood schizophrenia is lack of focus and attention, distractibility. That's more obvious in children with the illness, perhaps because they are more severely ill or because they are affected when younger.

I think that there is a lot of distractibility with adult onset cases too, and explains why many when young are diagnosed with attention deficit before an adult diagnosis of schizophrenia.

In fact, there are generally quite a few symptoms long before diagnosis, and more and more research suggests that schizophrenia starts long, long before it is actually diagnosed. Frankly, most of my folks have had mild symptoms for decades before they are even aware of being ill or had any obvious difficulties. They may feel isolated and cut off for years before they are obviously ill, due to these early symptoms. Most of my friends reported obvious and clear delusions and hallucinations from an early age, but these weren't consistent or prominent, just occasional.

A researcher recently reviewed home movies of kids, taken years before they were diagnosed with schizophrenia or had any obvious symptoms. ALL the patients, as toddlers, had noticeable abnormalities of eye gaze, grasping, crawling and reaching.

Posted by: slc at November 21, 2006 10:58 AM

SLC,

You're absolutely right here - I've talked to schizophrenia researchers who work with child psychiatry populations, and they tell me they see ADHD/ADD as a common early warning sign for schizophrenia.

This is annecdotal information - I'm not sure how common this view is.

B.

Posted by: Sz Administrator at November 21, 2006 03:52 PM

I have a 29 year old son. He started hearing voices after years of cocaine, heroin, etc use. He was put on standard meds for psychotic illness. It made him worse and a caused strange psychotic behavior. I took him off everything except bipolar depression meds and change his diet (veggies lean meats and no food additives) Took car keys away detoxed him, and within 5...yes 5 days! All voices WERE GONE! This might help someone out there!

Posted by: Sunne at February 23, 2007 09:10 AM

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