Cognitive performance and clinical features in adults with vulnerability to psychosis

Annamaria Wikström

Forskningsoutput: AvhandlingDoktorsavhandlingSamling av artiklar


Psychotic disorders are severe mental disorders with delusions, hallucinations and severe behavioural abnormalities that lead to a loss of contact with reality. Schizophrenia is the most severe psychotic disorder, but psychotic symptoms are not specific to schizophrenia. In addition to psychotic symptoms, alterations in drive and volition, affective dysregulation and cognitive deficits, such as difficulties in memory, attention and executive functioning, are often found in subjects with psychotic disorders. Currently, it is thought that vulnerability to psychosis is a continuum with individual differences existing in a person’s vulnerability to developing a psychotic disorder. Vulnerability may be due to a combined effect of personal genetic background and certain environmental stressors. Familial vulnerability is a known risk factor for future psychosis. Severe, acute forms of psychotic symptoms characterize disorders such as schizophrenia and psychotic bipolar disorder, but milder, subclinical psychotic-like experiences are also present in the general population. From previous studies it is known that non-psychotic family members of schizophrenia patients have mild cognitive deficits that manifest in neuropsychological tests. Also, among young age groups, subjects with psychotic-like experiences have often been found to have cognitive deficits which together with psychotic-like experiences have been found to predict future psychosis, at least in clinical high-risk populations. The present study aimed to explore aspects of vulnerability to psychotic disorders in two middle-aged populations who presumably have a more heightened susceptibility to psychotic disorders than the general population. Samples were drawn from large population-based studies, a schizophrenia family study and The Health 2000 and 2011 studies, from The National Institute for Health and Welfare (previously National Public Health Institute). It was found that among middle-aged subjects, healthy siblings from families with schizophrenia had mild cognitive deficits, even in the absence of a current non-psychotic psychiatric disorder. Elevated physical or social anhedonia was not found in siblings, suggesting that elevated anhedonia is more related to the illness than familial liability in middle-aged (above peak risk age for conversion to psychosis) subjects with a familial risk for psychosis. Psychotic-like experiences in middle-aged subjects may be more benign regarding risk for future psychosis than in younger age groups, since neither psychotic-like nor manic-like experiences at baseline predicted psychosis during eleven-year follow-up. However, results should be replicated in larger study groups, and if possible, with a longer follow-up period.
  • Tuulio-Henriksson, Annamari, Handledare
  • Suvisaari, Jaana, Handledare
  • Poutiainen, Erja, Handledare
Tryckta ISBN978-951-51-5087-5
Elektroniska ISBN978-951-51-5088-2
StatusPublicerad - 2019
MoE-publikationstypG5 Doktorsavhandling (artikel)


  • 515 Psykologi
  • 3124 Neurologi och psykiatri

Citera det här