Evidence map›Paper›PMID 42113003›Full record

ArticleSchizophrenia bulletin2026

Premorbid adjustment problems, negative symptoms, and cognitive impairment in a large international sample at clinical high risk for psychosis: Findings from the Accelerating Medicines Partnership-Schizophrenia.

Henry R Cowan, Danielle Pratt, Jai L Shah, Scott W Woods, Luis Alameda, Martin Lepage, Stewart A Shankman, Jean Addington, Celso Arango, Carrie E Bearden and 71 more

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Article in Schizophrenia bulletin, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 citing paper in PubMed.

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5 · Who and what money

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81 authors.

Henry R CowanDepartment of Psychology, Michigan State University, East Lansing, MI 44824, United States.
Danielle PrattDepartment of Psychology, Northwestern University, Evanston, IL 60208, United States.ORCID 0000-0003-1581-4317
Jai L ShahDouglas Research Centre, Montreal H4H 1R3, Canada.ORCID 0000-0002-7549-6990
Scott W WoodsDepartments of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, CT 06511, United States.
Luis AlamedaDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, National Psychosis Unit, South London and Maudsley NHS Foundation Trust, London WC2R 2LS, United Kingdom.
Martin LepageDouglas Research Centre, Montreal H4H 1R3, Canada.ORCID 0000-0003-4345-6502
Stewart A ShankmanDepartment of Psychiatry, Northwestern University, Chicago, IL 60611, United States.
Jean AddingtonDepartment of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4Z6, Canada.
Celso ArangoDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Instituto de Salud Carlos III, School of Medicine, Universidad Complutense, Madrid 28007, Spain.
Carrie E BeardenDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90024, United States.ORCID 0000-0002-8516-923X
Sylvain BouixDepartment of Software Engineering and Information Technology, École de Technologie Supérieure, Montréal, QC H3C 1K3, Canada.
Nicholas J K BreitbordeDepartment of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
Matthew R BroomeInstitute for Mental Health, University of Birmingham, Birmingham B15 2TT, United Kingdom.
Kristin S CadenheadDepartment of Psychiatry, University of California San Diego, San Diego, CA 92161, United States.ORCID 0000-0002-5952-4605
Monica E CalkinsDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States.ORCID 0000-0002-0546-0263
Rolando I Castillo-PassiDepartment of Psychiatry, IMHAY, University of Chile, Santiago 843 1807, Chile.
Eric Yu Hai ChenLKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.
Jimmy ChoiOlin Neuropsychiatry Research Center, Hartford HealthCare Behavioral Health Network, Hartford, CT 06106, United States.
Philippe ConusDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, National Psychosis Unit, South London and Maudsley NHS Foundation Trust, London WC2R 2LS, United Kingdom.
Cheryl M CorcoranDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
Barbara A CornblattDepartment of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, United States.
Covadonga M Diaz-CanejaDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Instituto de Salud Carlos III, School of Medicine, Universidad Complutense, Madrid 28007, Spain.ORCID 0000-0001-8538-3175
Lauren M EllmanDepartment of Psychology & Neuroscience, Temple University, Philadelphia, PA 19122, United States.
Paolo Fusar-PoliEarly Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, King's College London, London WC2R 2LS, United Kingdom.
Pablo A GasparDepartment of Psychiatry, IMHAY, University of Chile, Santiago 843 1807, Chile.
Carla GerberPrevention Science Institute, University of Oregon, Eugene, OR 97403, United States.
Louise Birkedal GlenthøjVIRTU Research Group, Copenhagen Research Centre for Mental Health, Mental Health Copenhagen, University of Copenhagen, Copenhagen 1850, Denmark.
Cláudia GonçalvesInstitute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia.ORCID 0000-0001-6767-0920
Leslie E HortonDepartment of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United States.
Christy Lai Ming HuiDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.
Joseph KambeitzDepartment of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne  50937, Cologne, Germany.ORCID 0000-0002-8988-3959
Lana Kambeitz-IlankovicDepartment of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne  50937, Cologne, Germany.
Rene S KahnDepartment of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, United States.
John M KaneDepartment of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, United States.ORCID 0000-0002-2628-9442
Matcheri S KeshavanDepartment of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States.
Minah KimDepartment of Neuropsychiatry, Seoul National University Hospital, Seoul 13620, South Korea.
Sung-Wan KimDepartment of Psychiatry, Chonnam National University Medical School, Gwangju 61469, South Korea.
Nikolaos KoutsoulerisDepartment of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich 80539, Germany.
Jun Soo KwonDepartment of Psychiatry, Hanyang University Hospital, Seoul 04763, South Korea.ORCID 0000-0002-1060-1462
Kerstin LangbeinDepartment of Psychiatry and Psychotherapy, Jena University Hospital, Jena 07747, Germany.
Daniel MamahDepartment of Psychiatry, Washington University Medical School, St. Louis, MO 63110, United States.
Daniel H MathalonDepartment of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, United States.
Patrick D McGorryCentre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia.
Barnaby NelsonCentre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia.
Merete NordentoftCopenhagen Research Centre for Mental Health, Mental Health Copenhagen, University of Copenhagen, Hellerup 2900, Denmark.
Ofer PasternakDepartment of Psychiatry and Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States.
Godfrey D PearlsonDepartments of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, CT 06511, United States.ORCID 0000-0002-7525-5185
Jesus PerezCAMEO, Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge CB21 5EF, United Kingdom.
Diana O PerkinsDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, United States.
Albert R PowersDepartments of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, CT 06511, United States.ORCID 0000-0003-3057-5043
Jack RogersInstitute for Mental Health, University of Birmingham, Birmingham B15 2TT, United Kingdom.
Fred W SabbPrevention Science Institute, University of Oregon, Eugene, OR 97403, United States.
Jason SchiffmanDepartment of Psychological Science, University of California, Irvine, Irvine, CA 92617, United States.
Martha E ShentonDepartment of Psychiatry and Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States.
Steven M SilversteinDepartment of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, United States.ORCID 0000-0002-0699-0960
Stefan SmesnyDepartment of Psychiatry and Psychotherapy, Jena University Hospital, Jena 07747, Germany.
William S StoneDepartment of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, and Harvard Medical School, Boston, MA 02215, United States.ORCID 0000-0003-2932-7288
Gregory P StraussDepartment of Psychology, University of Georgia, Athens, GA 30602, United States.
Judy L ThompsonDepartment of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, United States.
Rachel UpthegroveInstitute for Mental Health, University of Birmingham, Birmingham B15 2TT, United Kingdom.
Swapna VermaInstitute of Mental Health, Singapore 539747, Singapore.
Jijun WangShanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China.
Daniel H WolfDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States.
Alison YungInstitute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia.
Tianhong ZhangShanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China.
Courtney CrawfordDepartment of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States.
Walid YassinDepartment of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States.
Sinead KellyDepartment of Psychiatry and Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States.
Michael ColemanDepartment of Psychiatry and Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States.
Grace JacobsDepartment of Psychiatry and Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States.
Kathryn E LewandowskiSchizophrenia and Bipolar Disorder Program, McLean Hospital Department of Psychiatry, Harvard Medical School, Belmont, MA, 02478, United States.
Nora PenzelDepartment of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston 02114, MA, United States.
Justin BakerDepartment of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA 02115, United States.
Guillermo CecciIBM T.J. Watson Research Center, Yorktown Heights, NY 10598, United States.ORCID 0000-0003-1013-8348
Kelly AllottCentre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia.
Kate BuccilliCentre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia.
Sophie TodCentre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia.
Lauren AddamoCentre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia.
Lihua XuShanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China.
Accelerating Medicines Partnership®—Schizophrenia (AMP® SCZ)
Vijay A MittalDepartments of Psychology and Medical Social Science, Northwestern University, Evanston, IL 60208, United States.ORCID 0000-0001-9017-5119

Funding

ProNET: Psychosis-Risk Outcomes NetworkU01MH124639 · NIMH · YALE UNIVERSITY · PI CARRIE E BEARDEN, JOHN M KANE · 2020 to 2026
$81.2M
Psychosis Risk Evaluation, Data Integration and Computational Technologies (PREDICT): Data Processing, Analysis, and Coordination CenterU24MH124629 · NIMH · BRIGHAM AND WOMEN'S HOSPITAL · PI Rene S. Kahn, Martha E. Shenton · 2020 to 2026
$32.6M
Trajectories and Predictors in the Clinical High Risk for Psychosis Population: Prediction Scientific Global Consortium (PRESCIENT)U01MH124631 · NIMH · UNIVERSITY OF MELBOURNE · PI Christopher Barnaby Nelson · 2020 to 2026
$30.4M
AMP SCZ U01MH124631AMP SCZ U01MH124639AMP SCZ U24MH124629NARSAD Frederick & Alice Coles and Thomas & Nancy Coles Young Investigator Award 32738NHMRC CRE PREEMPT 1198304NIMH NIH HHS U01 MH124631NIMH NIH HHS U01 MH124639NIMH NIH HHS U24 MH124629Wellcome TrustWellcome Trust 220664/A/20/ZWellcome Trust 220664/Z/20/Z
6 · The paper itself

Abstract

background and hypothesesFunctional impairment often precedes attenuated psychotic symptoms (APS) in youth at clinical high risk (CHR) for psychosis. This impairment has been linked to baseline symptoms and cognition, but the roles of developmental stage of APS onset and comorbid depression/anxiety are not well understood. Accelerating Medicines Partnership-Schizophrenia's diverse international sample and broad symptom assessment facilitate a detailed analysis of premorbid functioning. STUDY

designPremorbid adjustment and baseline symptoms and cognition were examined in 1056 individuals at CHR (n = 482 early-symptom, n = 574 late-symptom [first CHR-level APS in childhood/early adolescence vs. late adolescence/adulthood]). In the late-symptom group, growth curve models tested adjustment trends from childhood through late adolescence. Incremental relationships between adjustment, symptoms, and cognition were tested controlling for depression/anxiety. STUDY

resultsPremorbid social maladjustment correlated with baseline negative symptoms (r ≥ .25, P < .001). Premorbid academic maladjustment correlated with baseline negative symptoms (r ≥ .17, P ≤ .007) and cognitive impairment (r ≥ .27, P ≤ .001). Effects did not differ between early- and late-symptom subgroups (Δr ≤ .12, z ≤ 2.00, P > .05). Social adjustment deteriorated over time in participants with more baseline negative symptoms (γ = 0.14, P < .001) or cognitive impairment (γ ≥ -0.01, P < .004), even when controlling for depression/anxiety. APS were generally unrelated to premorbid functioning. Effects were consistent in the subsample residing outside North America (n = 579).

conclusionsRelationships between premorbid adjustment, negative symptoms, and cognition were independent of depression/anxiety and developmental stage of CHR symptom onset. Baseline negative symptoms and cognitive impairment follow insidious and worsening functional problems originating in early clinical stages, prior to onset of APS.

Indexed as

Cognitive DysfunctionDepressionProdromal SymptomsPsychotic DisordersSchizophreniaSocial AdjustmentAdolescentAdultChildFemaleHumansMaleRiskYoung Adultcognitiondepressionfunctioningnegative symptomspremorbid adjustmentpsychosis risk

Identifiers

PMID42113003
PMCPMC13645657

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