Neuropsychology of subjects with ultra-high risk (UHR) of psychosis: A critical analysis of the literature

Abstract

Cognitive disorders are currently considered as central components of disorders found in schizophrenia and are a major handicap for patients day to day. These disorders appear before the first psychotic episode, in the prodromal phase, during which time the symptoms are below the threshold for psychosis. People with these symptoms are considered as presenting an at-risk mental state (or at ultra-high risk, UHR of psychosis) and their risk for psychotic transition is between 20% and 40% within one year. Despite a number of studies, the chronology in which cognitive disorders appear in relation to the psychotic symptoms has not clearly been established and the study of the links between cognition and symptoms could improve our understanding of psychotic disorders. The detection of certain cognitive disorders before the onset of psychotic disorders could help improve early detection. We carried out a systematic analysis of the literature exploring cognitive disorders found in subjects with UHR for psychosis. The objective of most studies was to establish the predictive value for psychotic transition. Nevertheless study results have shown little consensus. Faced with this heterogeneity of results from past studies, we carried out a critical analysis of the literature and suggest areas of reflection for future research.

Keywords: At-risk; Cognition; Conversion psychotique; Early psychosis; Prodromes; Psychose débutante; Psychotic conversion; Schizophrenia; Schizophrénie; À risque.