@article{discovery10205125,
           month = {February},
          volume = {55},
            note = {Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use and/or adaptation of the article.
Copyright
{\copyright} The Author(s), 2025. Published by Cambridge University Press},
           title = {Cognitive presentation at psychosis onset through premorbid deterioration and exposure to environmental risk factors},
            year = {2025},
         journal = {Psychological Medicine},
       publisher = {CAMBRIDGE UNIV PRESS},
          author = {Ferraro, Laura and Di Forti, Marta and La Barbera, Daniele and La Cascia, Caterina and Morgan, Craig and Tripoli, Giada and Jongsma, Hannah and Seminerio, Fabio and Sartorio, Crocettarachele and Sideli, Lucia and Tarricone, Ilaria and Carloni, Anna Lisa and Szoke, Andrei and Pignon, Baptiste and Bernardo, Miguel and de Haan, Lieuwe and Arango, Celso and Velthorst, Eva and Gayer-Anderson, Charlotte and Kirkbride, James and Rutten, Bart PF and Lasalvia, Antonio and Tosato, Sarah and Del Ben, Cristina Marta and Menezes, Paulo Rossi and Bobes, Julio and Arrojo, Manuel and Tortelli, Andrea and Jones, Peter and Selten, Jean-Paul and van Os, Jim and Murray, Robin and Quattrone, Diego and Vassos, Evangelos},
        keywords = {Social Sciences, Science \& Technology, Life Sciences \& Biomedicine, Psychology, Clinical, Psychiatry, Psychology, cannabis, childhood abuse, cluster analysis, IQ, risk factors, migration, CANNABIS USE, 1ST-EPISODE PSYCHOSIS, CHILDHOOD TRAUMA, SCHIZOPHRENIA, ADJUSTMENT, VALIDITY, QUESTIONNAIRE, METAANALYSIS, EXPERIENCES},
        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 ({\ensuremath{\beta}}=2.8, 95\% CI 2.3 3.4, {\ensuremath{\eta}}2 = 0.049) and the low-cognitive-functioning cluster ({\ensuremath{\beta}}=2.4, 95\% CI 1.9 2.8, {\ensuremath{\eta}}2 = 0.049) and distinguished them from the cluster with high-cognitive-functioning. The deteriorating cluster had higher cannabis exposure (meandifference = 0.48, 95\% CI 0.49 0.91) than the intermediate having identical IQ, and more people from an ethnic minority (meandifference = 0.77, 95\% CI 0.24 1.29) compared to the high-cognitive-functioning cluster. CONCLUSIONS: High exposure to environmental risk factors might result in cognitive impairment and lower-than-expected functioning in individuals at the onset of psychosis. Some patients' trajectories involved risk factors that could be modified by tailored interventions.},
            issn = {0033-2917},
             url = {https://doi.org/10.1017/s0033291724003507}
}