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Cognitive dysfunction is a core feature of schizophrenia, but it is not yet known whether it is present before the onset of psychosis (NEJM JW Psychiatry Sep 2015 and JAMA Psychiatry 2015; 72:803). These investigators performed neuropsychological testing on 689 people at clinically high risk for psychosis and 264 healthy controls (mean age, 19) and followed them for 2 years.
Compared with controls, high-risk participants had significant impairments on most tests. Impairments in attention, working memory, and declarative memory had a large effect size among the 89 people who developed psychosis. General cognitive ability, depression, medications, or substance abuse did not explain these findings. High-risk participants who developed psychosis…