Deconstructing Cognitive Impairment in Psychosis With a Machine Learning Approach

作者：Robert A. McCutcheon, Richard S.E. Keefe, Philip M. McGuire, André F. Marquand · 发表于：JAMA Psychiatry · 年份：2024 · DOI：10.1001/jamapsychiatry.2024.3062 · 被引用次数：17 · 研究领域：Schizophrenia research and treatment、Tryptophan and brain disorders、Bipolar Disorder and Treatment

Importance: Cognitive functioning is associated with various factors, such as age, sex, education, and childhood adversity, and is impaired in people with psychosis. In addition to specific effects of the disorder, cognitive impairments may reflect a greater exposure to general risk factors for poor cognition. Objective: To determine the extent that impairments in cognition in psychosis reflect risk factor exposures. Design, Setting, and Participants: This cross-sectional study examined the relationship between exposures and cognitive function using data from the Bipolar-Schizophrenia Network on Intermediate Phenotypes studies 1 and 2 across 6 sites. Participants included healthy controls; patients with schizophrenia, schizoaffective disorder, or bipolar I disorder with psychosis; and relatives of patients. Predictive modeling was performed using extreme gradient boosting regression to train a composite cognitive score prediction model with nested cross-validation. Shapley additive explanations values were used to examine the relationship between exposures and cognitive function. Exposure: Exposures were chosen based on associations with cognition previously identified: age, sex, race and ethnicity, childhood adversity, education, parental education, parental socioeconomic status, parental age at birth, substance use, antipsychotic dose, and diagnosis. Main Outcomes and Measures: Cognition was assessed using the Brief Assessment of Cognition in Schizophrenia. Results: A total...