TY - JOUR JF - Psychological Medicine A1 - Ferraro, Laura A1 - Di Forti, Marta A1 - La Barbera, Daniele A1 - La Cascia, Caterina A1 - Morgan, Craig A1 - Tripoli, Giada A1 - Jongsma, Hannah A1 - Seminerio, Fabio A1 - Sartorio, Crocettarachele A1 - Sideli, Lucia A1 - Tarricone, Ilaria A1 - Carloni, Anna Lisa A1 - Szoke, Andrei A1 - Pignon, Baptiste A1 - Bernardo, Miguel A1 - de Haan, Lieuwe A1 - Arango, Celso A1 - Velthorst, Eva A1 - Gayer-Anderson, Charlotte A1 - Kirkbride, James A1 - Rutten, Bart PF A1 - Lasalvia, Antonio A1 - Tosato, Sarah A1 - Del Ben, Cristina Marta A1 - Menezes, Paulo Rossi A1 - Bobes, Julio A1 - Arrojo, Manuel A1 - Tortelli, Andrea A1 - Jones, Peter A1 - Selten, Jean-Paul A1 - van Os, Jim A1 - Murray, Robin A1 - Quattrone, Diego A1 - Vassos, Evangelos KW - Social Sciences KW - Science & Technology KW - Life Sciences & Biomedicine KW - Psychology KW - Clinical KW - Psychiatry KW - Psychology KW - cannabis KW - childhood abuse KW - cluster analysis KW - IQ KW - risk factors KW - migration KW - CANNABIS USE KW - 1ST-EPISODE PSYCHOSIS KW - CHILDHOOD TRAUMA KW - SCHIZOPHRENIA KW - ADJUSTMENT KW - VALIDITY KW - QUESTIONNAIRE KW - METAANALYSIS KW - EXPERIENCES N2 - 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 (?=2.8, 95% CI 2.3 3.4, ?2 = 0.049) and the low-cognitive-functioning cluster (?=2.4, 95% CI 1.9 2.8, ?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. ID - discovery10205125 UR - https://doi.org/10.1017/s0033291724003507 PB - CAMBRIDGE UNIV PRESS SN - 0033-2917 N1 - 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 © The Author(s), 2025. Published by Cambridge University Press TI - Cognitive presentation at psychosis onset through premorbid deterioration and exposure to environmental risk factors VL - 55 AV - public Y1 - 2025/02/05/ EP - 11 ER -