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Neuropsychological Impairments in Schizophrenia and Psychotic Bipolar Disorder: Findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) Study

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TLDR
Robust cognitive deficits are present and familial in schizophrenia and psychotic bipolar disorder and Severity of cognitive impairments across psychotic disorders was consistent with a continuum model, in which more prominent affective features and less enduring psychosis were associated with less cognitive impairment.
Abstract
ObjectiveFamilial neuropsychological deficits are well established in schizophrenia but remain less well characterized in other psychotic disorders. This study from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium 1) compares cognitive impairment in schizophrenia and bipolar disorder with psychosis, 2) tests a continuum model of cognitive dysfunction in psychotic disorders, 3) reports familiality of cognitive impairments across psychotic disorders, and 4) evaluates cognitive impairment among nonpsychotic relatives with and without cluster A personality traits.MethodParticipants included probands with schizophrenia (N=293), psychotic bipolar disorder (N=227), schizoaffective disorder (manic, N=110; depressed, N=55), their first-degree relatives (N=316, N=259, N=133, and N=64, respectively), and healthy comparison subjects (N=295). All participants completed the Brief Assessment of Cognition in Schizophrenia (BACS) neuropsychological battery.ResultsCognitive impairments among...

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Identification of Distinct Psychosis Biotypes Using Brain-Based Biomarkers

TL;DR: These data illustrate how multiple pathways may lead to clinically similar psychosis manifestations, and they provide explanations for the marked heterogeneity observed across laboratories on the same biomarker variables when DSM diagnoses are used as the gold standard.
Journal ArticleDOI

The impact of environmental factors in severe psychiatric disorders.

TL;DR: Meta-analyses of structural MRI studies revealing hippocampal volume deficits in first-episode patients and in the longitudinal disease course confirm the neurodevelopmental hypothesis, which proposes schizophrenia to be related to genetic and environmental factors leading to abnormal brain development during the pre- or postnatal period.
Journal ArticleDOI

Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective.

TL;DR: The literature on cognitive deficits across the life span of individuals with psychotic disorder and psychotic-like experiences is reviewed, highlighting the dimensional nature of both psychosis and cognitive ability and identifying premorbid generalized cognitive impairment in schizophrenia that worsens throughout development and stabilizes by the first-episode of psychosis, suggesting a neurodevelopmental course.
Journal ArticleDOI

The slow death of the concept of schizophrenia and the painful birth of the psychosis spectrum

TL;DR: It is tentatively concluded that with the advent of broad spectrum phenotypes covering autism and addiction in DSM5, the prospect for introducing a psychosis spectrum disorder – and modernizing psychiatry – appears to be within reach.
References
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Journal ArticleDOI

Contributions of genetic risk and fetal hypoxia to hippocampal volume in patients with schizophrenia or schizoaffective disorder, their unaffected siblings, and healthy unrelated volunteers.

TL;DR: In patients with schizophrenia spectrum disorders, hippocampal volume is influenced in part by schizophrenia susceptibility genes and an interaction of these genes with fetal hypoxia, and it is suggested that hippocampusal volume in schizophrenia or schizoaffective disorder may be linked to time of disease onset.
Journal ArticleDOI

Neuropsychological performance of monozygotic twins discordant for bipolar disorder.

TL;DR: The data suggest that while some visuospatial deficits and verbal memory deficits may be features of bipolar disorder related to disease parameters, mild attenuations in overall memory or retrieval function may be related to genetic factors associated with the illness.
Journal ArticleDOI

A dimensional approach to the psychosis spectrum between bipolar disorder and schizophrenia: the Schizo-Bipolar Scale.

TL;DR: The data suggest a hybrid conceptualization model with a representation of cases with prototypic schizophrenia or bipolar disorder at the extremes, but a large group of patients on the continuum between them that traditionally would be considered schizoaffective.
Journal ArticleDOI

Differential working memory impairment in bipolar disorder and schizophrenia: effects of lifetime history of psychosis

TL;DR: Backward digit span performance is comparable in bipolar disorder and schizophrenia, and may be an appropriate endophenotypic marker that cuts across diagnostic categories, while spatial working memory performance clearly distinguishes non-psychotic bipolar disorder patients from patients with functional psychosis.
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