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Cognition in Psychotic Disorders, from Age 8 to 80
Psychotic disorders are associated with cognitive deficits. However, most observations of this association are cross sectional, and those studies that are longitudinal cover small portions of the lifespan. As a result, it is unknown to what extent cognitive deficits reflect slowed trajectories of cognitive development versus declines in functioning after psychosis onset. Furthermore, it is unclear whether these differences in cognitive trajectories reflect genetic liabilities or are a consequence of disease onset and treatment. We describe trajectories of cognitive growth and decline in a cohort of 628 individuals with psychotic disorders who were ascertained at first hospitalization for psychosis and then followed for quarter century. School records, including IQ and achievement test scores, were obtained for most participants. Cognition was assessed at first admission and five points thereafter. We show that developmental trajectories begin to diverge in early adolescence, and further deteriorate after illness onset. These trajectories are shown to be associated with genetic liabilities for schizophrenia.