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：

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精神病临床高风险人群与其他精神病理学低风险人群的神经心理学表现：系统评价和荟萃分析。

背景和假设 精神病临床高危 (CHR) 青年与健康对照者 (HC) 相比存在神经心理障碍，但这些障碍是否与具有其他精神病理学的假定低风险同龄人中看到的障碍有区别仍然未知。我们假设 CHR 队列中超出其他临床组的任何过度损伤都是最小的，并且由过渡到精神病 (CHR-T) 的比例来解释。研究设 研究结果 纳入了代表近 4000 名参与者的 21 项研究。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 的认知障碍最小（例如，整体认知：g = -0.13 [-0.20，- 0.06]）。CHR 中的任何过度减值几乎完全归因于 CHR-T；在没有过渡的 CHR (CHR-NT) 青年中的损伤通常与 CC 无法区分（例如，全局认知，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]; 工作记忆, CHR-T: g = -0.42 [ -0.62, -0.22], CHR-NT: g = -0.03 [-0.14, 0.08])。