Cognitive presentation at psychosis onset through premorbid deterioration and exposure to environmental risk factors

作者：Laura Ferraro, Marta Di Forti, Daniele La Barbera, Caterina La Cascia, Craig Morgan, Giada Tripoli, Hannah E. Jongsma, Fabio Seminerio, Crocettarachele Sartorio, Lucia Sideli, Ilaria Tarricone, A Carloni, Andreı̈ Szöke, Baptiste Pignon, Miquel Bernardo, Lieuwe de Haan, Celso Arango, Eva Velthorst, Charlotte Gayer‐Anderson, James B. Kirkbride, Bart P. F. Rutten, Antonio Lasalvia, Sarah Tosato, Cristina Marta Del‐Ben, Paulo Rossi Menezes, Julio Bobes, Manuel Arrojo, Andrea Tortelli, Peter Jones, Jean‐Paul Selten, Jim van Os, The WP2 EU-GEI Group, Robin Murray, Diego Quattrone, Evangelos Vassos · 发表于：Psychological Medicine · 年份：2025 · DOI：10.1017/s0033291724003507 · 被引用次数：7 · 研究领域：Schizophrenia research and treatment、Bipolar Disorder and Treatment、Mental Health and Psychiatry

Abstract Background Previous studies identified clusters of first-episode psychosis (FEP) patients based on cognition and premorbid adjustment. This study examined a range of socio-environmental risk factors associated with clusters of FEP, aiming a) to compare clusters of FEP and community controls using the Maudsley Environmental Risk Score for psychosis (ERS), a weighted sum of the following risks: paternal age, childhood adversities, cannabis use, and ethnic minority membership; b) to explore the putative differences in specific environmental risk factors in distinguishing within patient clusters and from controls. Methods A univariable general linear model (GLS) compared the ERS between 1,263 community controls and clusters derived from 802 FEP patients, namely, low (n = 223) and high-cognitive-functioning (n = 205), intermediate (n = 224) and deteriorating (n = 150), from the EU-GEI study. A multivariable GLS compared clusters and controls by different exposures included in the ERS. Results The ERS was higher in all clusters compared to controls, mostly in the deteriorating ( β =2.8, 95% CI 2.3 3.4 , η 2 = 0.049) and the low-cognitive-functioning cluster ( β =2.4, 95% CI 1.9 2.8, η 2 = 0.049) and distinguished them from the cluster with high-cognitive-functioning. The deteriorating cluster had higher cannabis exposure (mean difference = 0.48, 95% CI 0.49 0.91) than the intermediate having identical IQ, and more people from an ethnic minority (mean difference = 0.77, 95%...