BACKGROUND AND HYPOTHESIS Youth at clinical high-risk (CHR) for psychosis present with neuropsychological impairments relative to healthy controls (HC), but whether these impairments are distinguishable from those seen among putatively lower risk peers with other psychopathology remains unknown. We hypothesized that any excess impairment among CHR cohorts beyond that seen in other clinical groups is minimal and accounted for by the proportion who transition to psychosis (CHR-T). STUDY DESIGN We performed a systematic review and meta-analysis of studies comparing cognitive performance among CHR youth to clinical comparators (CC) who either sought mental health services but did not meet CHR criteria or presented with verified nonpsychotic psychopathology. STUDY RESULTS Twenty-one studies were included representing nearly 4000 participants. Individuals at CHR showed substantial cognitive impairments relative to HC (eg, global cognition: g = -0.48 [-0.60, -0.34]), but minimal impairments relative to CC (eg, global cognition: g = -0.13 [-0.20, -0.06]). Any excess impairment among CHR was almost entirely attributable to CHR-T; impairment among youth at CHR without transition (CHR-NT) was typically indistinguishable from CC (eg, global cognition, CHR-T: g = -0.42 [-0.64, -0.19], CHR-NT: g = -0.09 [-0.18, 0.00]; processing speed, CHR-T: g = -0.59 [-0.82, -0.37], CHR-NT: g = -0.12 [-0.25, 0.07]; working memory, CHR-T: g = -0.42 [-0.62, -0.22], CHR-NT: g = -0.03 [-0.14, 0.08]). CONCLUSIONS Neurocognitive impairment in CHR cohorts should be interpreted cautiously when psychosis or even CHR status is the specific clinical syndrome of interest as these impairments most likely represent a transdiagnostic vs psychosis-specific vulnerability.

中文翻译：

---

精神病临床高风险个体与其他精神病理学的假定低风险个体的神经心理学表现：系统回顾和荟萃分析。


背景和假设 与健康对照组（HC）相比，精神病临床高风险（CHR）青少年存在神经心理损伤，但这些损伤是否与患有其他精神病理学的假定风险较低的同龄人中所见的损伤不同，仍不清楚。我们假设 CHR 队列中超出其他临床组中所见的任何过度损伤都是最小的，并且可以通过转变为精神病 (CHR-T) 的比例来解释。研究设计 我们对 CHR 青少年的认知表现与临床对照者 (CC) 的认知表现进行了系统回顾和荟萃分析，临床对照者要么寻求心理健康服务，但不符合 CHR 标准，要么呈现经过验证的非精神病性精神病理学。研究结果 纳入了 21 项研究，代表近 4000 名参与者。 CHR 的个体表现出相对于 HC 的严重认知障碍（例如，整体认知：g = -0.48 [-0.60，-0.34]），但相对于 CC 的认知障碍很小（例如，整体认知：g = -0.13 [-0.20，- 0.06]）。 CHR 中的任何超额减值几乎完全归因于 CHR-T；没有过渡的 CHR (CHR-NT) 青少年中的损伤通常与 CC 没有区别（例如，整体认知，CHR-T：g = -0.42 [-0.64，-0.19]，CHR-NT：g = -0.09 [-0.18 ，0.00]；处理速度，CHR-T：g = -0.59 [-0.82，-0.37]，CHR-NT：g = -0.12 [-0.25，0.07]；工作内存，CHR-T：g = -0.42 [ -0.62，-0.22]，CHR-NT：g = -0.03 [-0.14，0.08]）。结论 当精神病甚至 CHR 状态是感兴趣的特定临床综合征时，CHR 队列中的神经认知损伤应谨慎解释，因为这些损伤很可能代表跨诊断与精神病特异性的脆弱性。