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Cross-Disorder Cognitive Impairments in Youth Referred for Neuropsychiatric Evaluation

Published online by Cambridge University Press:  04 August 2017

Alysa E. Doyle ,
Pieter J. Vuijk ,
Nathan D. Doty ,
Lauren M. McGrath ,
Brian L. Willoughby ,
Ellen H. O’Donnell ,
H. Kent Wilson ,
Mary K. Colvin ,
Deanna C. Toner  and
Kelsey E. Hudson
...Show all authors
Alysa E. Doyle*
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts Stanley Center for Psychiatric Research, Broad Institute, Cambridge, Massachusetts
Pieter J. Vuijk
Affiliation:
Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts
Nathan D. Doty
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
Lauren M. McGrath
Affiliation:
Department of Psychology, University of Denver, Denver, Colorado
Brian L. Willoughby
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
Ellen H. O’Donnell
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
H. Kent Wilson
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
Mary K. Colvin
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
Deanna C. Toner
Affiliation:
Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts
Kelsey E. Hudson
Affiliation:
Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts
Jessica E. Blais
Affiliation:
Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts
Hillary L. Ditmars
Affiliation:
Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts
Stephen V. Faraone
Affiliation:
Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York
Larry J. Seidman
Affiliation:
Harvard Medical School, Boston, Massachusetts Commonwealth Research Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Ellen B. Braaten
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
*
Correspondence and reprint requests to: Alysa E. Doyle, Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, CPZN 6240, Boston, MA 02114. E-mail: doylea@helix.mgh.harvard.edu
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Abstract

Objectives: Studies suggest that impairments in some of the same domains of cognition occur in different neuropsychiatric conditions, including those known to share genetic liability. Yet, direct, multi-disorder cognitive comparisons are limited, and it remains unclear whether overlapping deficits are due to comorbidity. We aimed to extend the literature by examining cognition across different neuropsychiatric conditions and addressing comorbidity. Methods: Subjects were 486 youth consecutively referred for neuropsychiatric evaluation and enrolled in the Longitudinal Study of Genetic Influences on Cognition. First, we assessed general ability, reaction time variability (RTV), and aspects of executive functions (EFs) in youth with non-comorbid forms of attention-deficit/hyperactivity disorder (ADHD), mood disorders and autism spectrum disorder (ASD), as well as in youth with psychosis. Second, we determined the impact of comorbid ADHD on cognition in youth with ASD and mood disorders. Results: For EFs (working memory, inhibition, and shifting/ flexibility), we observed weaknesses in all diagnostic groups when participants’ own ability was the referent. Decrements were subtle in relation to published normative data. For RTV, weaknesses emerged in youth with ADHD and mood disorders, but trend-level results could not rule out decrements in other conditions. Comorbidity with ADHD did not impact the pattern of weaknesses for youth with ASD or mood disorders but increased the magnitude of the decrement in those with mood disorders. Conclusions: Youth with ADHD, mood disorders, ASD, and psychosis show EF weaknesses that are not due to comorbidity. Whether such cognitive difficulties reflect genetic liability shared among these conditions requires further study. (JINS, 2018, 24, 91–103)

Keywords

Executive functionsReaction time variability (RTV)ADHDAutism spectrum disorderMood disordersPsychosis
Type
Special Section: Lifespan Neuropsychology
Information
Journal of the International Neuropsychological Society , Volume 24 , Issue 1 , January 2018 , pp. 91 - 103
Copyright
Copyright © The International Neuropsychological Society 2017 

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