Neurocognitive subgroups among newly diagnosed patients with schizophrenia spectrum or bipolar disorders

Neurocognitive subgroups among newly diagnosed patients with schizophrenia spectrum or bipolar disorders: A hierarchical cluster analysis

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Miskowiak, Kamilla
H. L. Kjærstad
C. K. Lemvigh
K. S. Ambrosen
M. S. Thorvald
Kessing, Lars Vedel
Glenthøj, Birte Yding
Ebdrup, Bjørn
Fagerlund, Birgitte

Studies across schizophrenia (SZ) and bipolar disorder (BD) indicate common transdiagnostic neurocognitive subgroups. However, existing studies of patients with long-term illness precludes insight into whether impairments result from effects of chronic illness, medication or other factors. This study aimed to investigate whether neurocognitive subgroups across SZ and BD can be demonstrated during early illness stages. Data from overlapping neuropsychological tests were pooled from cohort studies of antipsychotic-naïve patients with first-episode SZ spectrum disorders (n = 150), recently diagnosed BD (n = 189) or healthy controls (HC) (n = 280). Hierarchical cluster analysis was conducted to examine if transdiagnostic subgroups could be identified based on the neurocognitive profile. Patterns of cognitive impairments and patient characteristics across subgroups were examined. Patients could be clustered into two, three and four subgroups, of which the three-cluster solution (with 83% accuracy) was selected for posthoc analyses. This solution revealed a subgroup covering 39% of patients (predominantly BD) who were cognitively relatively intact, a subgroup of 33% of patients (more equal distributions of SZ and BD) displaying selective deficits, particularly in working memory and processing speed, and a subgroup of 28% (mainly SZ) with global impairments. The globally impaired group exhibited lower estimated premorbid intelligence than the other subgroups. Globally impaired BD patients also showed more functional disability than cognitively relatively intact patients. No differences were observed across subgroups in symptoms or medications. Neurocognitive results can be understood by clustering analysis with similar clustering solutions occurring across diagnoses. The subgroups were not explained by clinical symptoms or medication, suggesting neurodevelopmental origins.

Originalsprog	Engelsk
Tidsskrift	Journal of Psychiatric Research
Vol/bind	163
Sider (fra-til)	278-287
Antal sider	10
ISSN	0022-3956
DOI	https://doi.org/10.1016/j.jpsychires.2023.05.025
Status	Udgivet - 2023

Bibliografisk note

Funding Information:
The BIO study is funded by grants from the Mental Health Services, Capital Region of Denmark, The Danish Council for Independent Research, Medical Sciences (DFF-4183-00570), Weimans Fund, Markedsmodningsfonden (the Market Development Fund, 2015–310), Gangstedfonden (A29594), Helsefonden (16-B-0063), Innovation Fund Denmark (the Innovation Fund, Denmark, 5164-00001 B), Copenhagen Center for Health Technology (CACHET), EU H2020 ITN (EU project 722561), Augustinusfonden (16–0083), and The Capital Region of Denmark (A6924).The schizophrenia studies were supported by the Mental Health Services, The Capital Region, Denmark; and The Lundbeck Foundation (grant numbers: R25-A2701 and R155-2013-16337). None of the funding sources had any involvement in the research or article.KWM has received consultancy fees from Lundbeck, Allergan and Janssen in the past three years. LVK has received consultancy fees from Lundbeck and Teva in the past three years. BHE has received lecture fees and/or is part of Advisory Boards of Bristol-Myers Squibb, Eli Lilly and Company, Janssen-Cilag, Otsuka Pharma Scandinavia AB, Takeda Pharmaceutical Company and Lundbeck Pharma A/S. Dr. Glenthøj has been the leader of a Lundbeck Foundation Center of Excellence for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) (January 2009–December 2021), which was partially financed by an independent grant from the Lundbeck Foundation based on international review and partially financed by the Mental Health Services in the Capital Region of Denmark, the University of Copenhagen, and other foundations. All grants are the property of the Mental Health Services in the Capital Region of Denmark and administrated by them. She has no other conflicts to disclose. CKL, KSA, BF, HLK report no conflicts of interest.

Funding Information:
The schizophrenia studies were supported by the Mental Health Services, The Capital Region, Denmark ; and The Lundbeck Foundation (grant numbers: R25-A2701 and R155-2013-16337 ). None of the funding sources had any involvement in the research or article.

Funding Information:
The BIO study is funded by grants from the Mental Health Services , Capital Region of Denmark , The Danish Council for Independent Research, Medical Sciences ( DFF-4183-00570 ), Weimans Fund , Markedsmodningsfonden (the Market Development Fund, 2015–310 ), Gangstedfonden ( A29594 ), Helsefonden ( 16-B-0063 ), Innovation Fund Denmark (the Innovation Fund, Denmark , 5164-00001 B ), Copenhagen Center for Health Technology (CACHET) , EU H2020 ITN (EU project 722561 ), Augustinusfonden ( 16–0083 ), and The Capital Region of Denmark ( A6924 ).

Publisher Copyright:
© 2023 The Authors

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