Cognitive presentation at psychosis onset through premorbid deterioration and exposure to environmental risk factors

The WP2 EU-GEI Group

doi:10.1017/S0033291724003507

Cognitive presentation at psychosis onset through premorbid deterioration and exposure to environmental risk factors

The WP2 EU-GEI Group

Research output: Contribution to journal › Article › peer-review

Abstract

Background Previous studies identified clusters of first-episode psychosis (FEP) patients based on cognition and premorbid adjustment. This study examined a range of socio-environmental risk factors associated with clusters of FEP, aiming a) to compare clusters of FEP and community controls using the Maudsley Environmental Risk Score for psychosis (ERS), a weighted sum of the following risks: paternal age, childhood adversities, cannabis use, and ethnic minority membership; b) to explore the putative differences in specific environmental risk factors in distinguishing within patient clusters and from controls. Methods A univariable general linear model (GLS) compared the ERS between 1,263 community controls and clusters derived from 802 FEP patients, namely, low (n = 223) and high-cognitive-functioning (n = 205), intermediate (n = 224) and deteriorating (n = 150), from the EU-GEI study. A multivariable GLS compared clusters and controls by different exposures included in the ERS. Results The ERS was higher in all clusters compared to controls, mostly in the deteriorating (β=2.8, 95% CI 2.3 3.4, η² = 0.049) and the low-cognitive-functioning cluster (β=2.4, 95% CI 1.9 2.8, η² = 0.049) and distinguished them from the cluster with high-cognitive-functioning. The deteriorating cluster had higher cannabis exposure (meandifference = 0.48, 95% CI 0.49 0.91) than the intermediate having identical IQ, and more people from an ethnic minority (meandifference = 0.77, 95% CI 0.24 1.29) compared to the high-cognitive-functioning cluster. Conclusions High exposure to environmental risk factors might result in cognitive impairment and lower-than-expected functioning in individuals at the onset of psychosis. Some patients' trajectories involved risk factors that could be modified by tailored interventions.

Original language	English
Article number	e12
Journal	Psychological Medicine
Volume	55
DOIs	https://doi.org/10.1017/S0033291724003507
Publication status	Published - 5 Feb 2025

Keywords

cannabis
childhood abuse
cluster analysis
IQ
migration
risk factors

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1017/S0033291724003507

Cite this

@article{ca9e84b4d5124b1ea2424db1eb5ced1d,

title = "Cognitive presentation at psychosis onset through premorbid deterioration and exposure to environmental risk factors",

abstract = "Background Previous studies identified clusters of first-episode psychosis (FEP) patients based on cognition and premorbid adjustment. This study examined a range of socio-environmental risk factors associated with clusters of FEP, aiming a) to compare clusters of FEP and community controls using the Maudsley Environmental Risk Score for psychosis (ERS), a weighted sum of the following risks: paternal age, childhood adversities, cannabis use, and ethnic minority membership; b) to explore the putative differences in specific environmental risk factors in distinguishing within patient clusters and from controls. Methods A univariable general linear model (GLS) compared the ERS between 1,263 community controls and clusters derived from 802 FEP patients, namely, low (n = 223) and high-cognitive-functioning (n = 205), intermediate (n = 224) and deteriorating (n = 150), from the EU-GEI study. A multivariable GLS compared clusters and controls by different exposures included in the ERS. Results The ERS was higher in all clusters compared to controls, mostly in the deteriorating (β=2.8, 95% CI 2.3 3.4, η2 = 0.049) and the low-cognitive-functioning cluster (β=2.4, 95% CI 1.9 2.8, η2 = 0.049) and distinguished them from the cluster with high-cognitive-functioning. The deteriorating cluster had higher cannabis exposure (meandifference = 0.48, 95% CI 0.49 0.91) than the intermediate having identical IQ, and more people from an ethnic minority (meandifference = 0.77, 95% CI 0.24 1.29) compared to the high-cognitive-functioning cluster. Conclusions High exposure to environmental risk factors might result in cognitive impairment and lower-than-expected functioning in individuals at the onset of psychosis. Some patients' trajectories involved risk factors that could be modified by tailored interventions.",

keywords = "cannabis, childhood abuse, cluster analysis, IQ, migration, risk factors",

author = "{The WP2 EU-GEI Group} and Laura Ferraro and {Di Forti}, Marta and {La Barbera}, Daniele and {La Cascia}, Caterina and Craig Morgan and Giada Tripoli and Hannah Jongsma and Fabio Seminerio and Crocettarachele Sartorio and Lucia Sideli and Ilaria Tarricone and Carloni, {Anna Lisa} and Andrei Szoke and Baptiste Pignon and Miguel Bernardo and {De Haan}, Lieuwe and Celso Arango and Eva Velthorst and Charlotte Gayer-Anderson and James Kirkbride and Rutten, {Bart P.F.} and Antonio Lasalvia and Sarah Tosato and {Del Ben}, {Cristina Marta} and Menezes, {Paulo Rossi} and Julio Bobes and Manuel Arrojo and Andrea Tortelli and Peter Jones and Selten, {Jean Paul} and {Van Os}, Jim and Robin Murray and Diego Quattrone and Evangelos Vassos",

note = "Publisher Copyright: {\textcopyright} The Author(s), 2025. Published by Cambridge University Press.",

year = "2025",

month = feb,

day = "5",

doi = "10.1017/S0033291724003507",

language = "English",

volume = "55",

journal = "Psychological Medicine",

issn = "0033-2917",

publisher = "Cambridge University Press",

}

TY - JOUR

T1 - Cognitive presentation at psychosis onset through premorbid deterioration and exposure to environmental risk factors

AU - The WP2 EU-GEI Group

AU - Ferraro, Laura

AU - Di Forti, Marta

AU - La Barbera, Daniele

AU - La Cascia, Caterina

AU - Morgan, Craig

AU - Tripoli, Giada

AU - Jongsma, Hannah

AU - Seminerio, Fabio

AU - Sartorio, Crocettarachele

AU - Sideli, Lucia

AU - Tarricone, Ilaria

AU - Carloni, Anna Lisa

AU - Szoke, Andrei

AU - Pignon, Baptiste

AU - Bernardo, Miguel

AU - De Haan, Lieuwe

AU - Arango, Celso

AU - Velthorst, Eva

AU - Gayer-Anderson, Charlotte

AU - Kirkbride, James

AU - Rutten, Bart P.F.

AU - Lasalvia, Antonio

AU - Tosato, Sarah

AU - Del Ben, Cristina Marta

AU - Menezes, Paulo Rossi

AU - Bobes, Julio

AU - Arrojo, Manuel

AU - Tortelli, Andrea

AU - Jones, Peter

AU - Selten, Jean Paul

AU - Van Os, Jim

AU - Murray, Robin

AU - Quattrone, Diego

AU - Vassos, Evangelos

PY - 2025/2/5

Y1 - 2025/2/5

N2 - Background Previous studies identified clusters of first-episode psychosis (FEP) patients based on cognition and premorbid adjustment. This study examined a range of socio-environmental risk factors associated with clusters of FEP, aiming a) to compare clusters of FEP and community controls using the Maudsley Environmental Risk Score for psychosis (ERS), a weighted sum of the following risks: paternal age, childhood adversities, cannabis use, and ethnic minority membership; b) to explore the putative differences in specific environmental risk factors in distinguishing within patient clusters and from controls. Methods A univariable general linear model (GLS) compared the ERS between 1,263 community controls and clusters derived from 802 FEP patients, namely, low (n = 223) and high-cognitive-functioning (n = 205), intermediate (n = 224) and deteriorating (n = 150), from the EU-GEI study. A multivariable GLS compared clusters and controls by different exposures included in the ERS. Results The ERS was higher in all clusters compared to controls, mostly in the deteriorating (β=2.8, 95% CI 2.3 3.4, η2 = 0.049) and the low-cognitive-functioning cluster (β=2.4, 95% CI 1.9 2.8, η2 = 0.049) and distinguished them from the cluster with high-cognitive-functioning. The deteriorating cluster had higher cannabis exposure (meandifference = 0.48, 95% CI 0.49 0.91) than the intermediate having identical IQ, and more people from an ethnic minority (meandifference = 0.77, 95% CI 0.24 1.29) compared to the high-cognitive-functioning cluster. Conclusions High exposure to environmental risk factors might result in cognitive impairment and lower-than-expected functioning in individuals at the onset of psychosis. Some patients' trajectories involved risk factors that could be modified by tailored interventions.

AB - Background Previous studies identified clusters of first-episode psychosis (FEP) patients based on cognition and premorbid adjustment. This study examined a range of socio-environmental risk factors associated with clusters of FEP, aiming a) to compare clusters of FEP and community controls using the Maudsley Environmental Risk Score for psychosis (ERS), a weighted sum of the following risks: paternal age, childhood adversities, cannabis use, and ethnic minority membership; b) to explore the putative differences in specific environmental risk factors in distinguishing within patient clusters and from controls. Methods A univariable general linear model (GLS) compared the ERS between 1,263 community controls and clusters derived from 802 FEP patients, namely, low (n = 223) and high-cognitive-functioning (n = 205), intermediate (n = 224) and deteriorating (n = 150), from the EU-GEI study. A multivariable GLS compared clusters and controls by different exposures included in the ERS. Results The ERS was higher in all clusters compared to controls, mostly in the deteriorating (β=2.8, 95% CI 2.3 3.4, η2 = 0.049) and the low-cognitive-functioning cluster (β=2.4, 95% CI 1.9 2.8, η2 = 0.049) and distinguished them from the cluster with high-cognitive-functioning. The deteriorating cluster had higher cannabis exposure (meandifference = 0.48, 95% CI 0.49 0.91) than the intermediate having identical IQ, and more people from an ethnic minority (meandifference = 0.77, 95% CI 0.24 1.29) compared to the high-cognitive-functioning cluster. Conclusions High exposure to environmental risk factors might result in cognitive impairment and lower-than-expected functioning in individuals at the onset of psychosis. Some patients' trajectories involved risk factors that could be modified by tailored interventions.

KW - cannabis

KW - childhood abuse

KW - cluster analysis

KW - IQ

KW - migration

KW - risk factors

UR - http://www.scopus.com/inward/record.url?scp=85217575554&partnerID=8YFLogxK

U2 - 10.1017/S0033291724003507

DO - 10.1017/S0033291724003507

M3 - Article

C2 - 39905765

AN - SCOPUS:85217575554

SN - 0033-2917

VL - 55

JO - Psychological Medicine

JF - Psychological Medicine

M1 - e12

ER -

Cognitive presentation at psychosis onset through premorbid deterioration and exposure to environmental risk factors

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this