{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T22:07:35Z","timestamp":1794002855441,"version":"4.8.0"},"reference-count":80,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"unspecified","delay-in-days":35,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2012\/0417-0"],"award-info":[{"award-number":["2012\/0417-0"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000764","name":"King's College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000764","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019418","name":"NIHR Maudsley Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019418","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S0033291724003507_sec1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>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.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0033291724003507_sec2\" sec-type=\"methods\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>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.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0033291724003507_sec3\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>The ERS was higher in all clusters compared to controls, mostly in the deteriorating (<jats:bold>\u03b2<\/jats:bold>=2.8, 95% CI 2.3 3.4<jats:sub>,<\/jats:sub> \u03b7<jats:sup>2<\/jats:sup> = 0.049) and the low-cognitive-functioning cluster (<jats:bold>\u03b2<\/jats:bold>=2.4, 95% CI 1.9 2.8, \u03b7<jats:sup>2<\/jats:sup> = 0.049) and distinguished them from the cluster with high-cognitive-functioning. The deteriorating cluster had higher cannabis exposure (mean<jats:sub>difference<\/jats:sub> = 0.48, 95% CI 0.49 0.91) than the intermediate having identical IQ, and more people from an ethnic minority (mean<jats:sub>difference<\/jats:sub> = 0.77, 95% CI 0.24 1.29) compared to the high-cognitive-functioning cluster.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0033291724003507_sec4\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>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\u2019 trajectories involved risk factors that could be modified by tailored interventions.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s0033291724003507","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T06:43:27Z","timestamp":1738737807000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":10,"title":["Cognitive presentation at psychosis onset through premorbid deterioration and exposure to environmental risk factors"],"prefix":"10.1017","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1205-2356","authenticated-orcid":false,"given":"Laura","family":"Ferraro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Di Forti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"La Barbera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"La Cascia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giada","family":"Tripoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Jongsma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Seminerio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crocettarachele","family":"Sartorio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Sideli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Tarricone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Lisa","family":"Carloni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Szoke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baptiste","family":"Pignon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Bernardo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lieuwe","family":"de Haan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celso","family":"Arango","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Velthorst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Gayer-Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Kirkbride","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart P. F.","family":"Rutten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Lasalvia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Tosato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Marta","family":"Del Ben","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Rossi","family":"Menezes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"Bobes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Arrojo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Tortelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Paul","family":"Selten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"van Os","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The WP2 EU-GEI Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Murray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Quattrone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Vassos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"S0033291724003507_r58","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2006.10.008"},{"key":"S0033291724003507_r56","unstructured":"Quattrone, D. , Ferraro, L. , Tripoli, G. , La Cascia, C. , Quigley, H. , Quattrone, A. , Jongsma, H. , Del Peschio, S. , Gatto, G. , EU-GEI_GROUP, Gayer-Anderson, C. , Jones, P. B. , Kirkbride, J. B. , La Barbera, D. , Tarricone, I. , Tosato, S. , Lasalvia, A. , Sz\u00f6ke, A. , Arango, C. \u2026 Di Forti, M. (2020). Daily use of high potency cannabis is associated with more positive symptoms in first episode psychosis patients: The EU-GEI case-control study. Psychological Medicine. https:\/\/kclpure.kcl.ac.uk\/portal\/en\/publications\/daily-use-of-high-potency-cannabis-is-associated-with-more-positive-symptoms-in-first-episode-psychosis-patients-the-eugei-casecontrol-study(8eacce06-6190-4eb5-9076-475a76f37cf8).html."},{"key":"S0033291724003507_r2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmen.0000134"},{"key":"S0033291724003507_r78","volume-title":"WAIS-R: Manual\u00a0: Wechsler adult intelligence scale-revised","author":"Wechsler","year":"1981"},{"key":"S0033291724003507_r43","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2021.2983"},{"key":"S0033291724003507_r24","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2013.07.046"},{"key":"S0033291724003507_r39","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbaa174"},{"key":"S0033291724003507_r55","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbz054"},{"key":"S0033291724003507_r59","doi-asserted-by":"publisher","DOI":"10.31887\/DCNS.2005.7.1\/areichenberg"},{"key":"S0033291724003507_r13","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579416001280"},{"key":"S0033291724003507_r68","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2018.06.029"},{"key":"S0033291724003507_r60","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2023.115053"},{"key":"S0033291724003507_r69","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2023.11.015"},{"key":"S0033291724003507_r31","doi-asserted-by":"publisher","DOI":"10.1038\/tp.2016.294"},{"key":"S0033291724003507_r27","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-020-01831-x"},{"key":"S0033291724003507_r20","unstructured":"EU-GEI. (2009). The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions. https:\/\/cordis.europa.eu\/project\/id\/241909\/reporting\/it."},{"key":"S0033291724003507_r41","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-002-0557-4"},{"key":"S0033291724003507_r9","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbm128"},{"key":"S0033291724003507_r44","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1206820109"},{"key":"S0033291724003507_r46","first-page":"100246","article-title":"A systematic review of premorbid cognitive functioning and its timing of onset in schizophrenia spectrum disorders","volume":"28","author":"Mohn-Haugen","year":"2022","journal-title":"Schizophrenia Research: Cognition"},{"key":"S0033291724003507_r79","doi-asserted-by":"publisher","DOI":"10.1017\/neu.2016.58"},{"key":"S0033291724003507_r30","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62036-X"},{"key":"S0033291724003507_r7","doi-asserted-by":"publisher","DOI":"10.1348\/014466505X35344"},{"key":"S0033291724003507_r80","doi-asserted-by":"publisher","DOI":"10.1186\/s41256-018-0088-5"},{"key":"S0033291724003507_r45","doi-asserted-by":"publisher","DOI":"10.1016\/0920-9964(94)90034-5"},{"key":"S0033291724003507_r12","first-page":"2","article-title":"Clusters, dimensions, and hierarchies: Finding a path forward for the neuroscience of mental disorders?","volume":"3","author":"Carter","year":"2018","journal-title":"Biological Psychiatry: Cognitive Neuroscience and Neuroimaging"},{"key":"S0033291724003507_r33","doi-asserted-by":"publisher","DOI":"10.1017\/S003329172000029X"},{"key":"S0033291724003507_r23","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbac100"},{"key":"S0033291724003507_r48","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717001970"},{"key":"S0033291724003507_r77","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-020-00969-z"},{"key":"S0033291724003507_r71","doi-asserted-by":"publisher","DOI":"10.1017\/S003329172000495X"},{"key":"S0033291724003507_r10","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/8.3.470"},{"key":"S0033291724003507_r36","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbp143"},{"key":"S0033291724003507_r37","doi-asserted-by":"publisher","DOI":"10.1007\/7854_2022_378"},{"key":"S0033291724003507_r67","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbac004"},{"key":"S0033291724003507_r19","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2019.19050527"},{"key":"S0033291724003507_r65","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2019.08.028"},{"key":"S0033291724003507_r28","doi-asserted-by":"publisher","DOI":"10.1159\/000495697"},{"key":"S0033291724003507_r15","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2022.12.016"},{"key":"S0033291724003507_r17","first-page":"14","article-title":"Challenging the hypothesized link to season of birth in patients with schizophrenia","volume":"8","author":"Demler","year":"2011","journal-title":"Innovations in Clinical Neuroscience"},{"key":"S0033291724003507_r32","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2017.3554"},{"key":"S0033291724003507_r40","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30060-9"},{"key":"S0033291724003507_r5","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jst084"},{"key":"S0033291724003507_r50","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2010.10.001"},{"key":"S0033291724003507_r63","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(15)00363-6"},{"key":"S0033291724003507_r76","doi-asserted-by":"publisher","DOI":"10.1080\/13546805.2012.731390"},{"key":"S0033291724003507_r66","doi-asserted-by":"publisher","DOI":"10.1111\/eip.12285"},{"key":"S0033291724003507_r14","unstructured":"CORDIS. (2019). Final report summary \u2013 EU-GEI (European Network of National Schizophrenia Networks Studying Gene-Environment Interactions) _ Report Summary _ EU-GEI _ FP7 _ CORDIS _ European Commission.pdf. https:\/\/cordis.europa.eu\/project\/id\/241909\/reporting\/it."},{"key":"S0033291724003507_r34","doi-asserted-by":"publisher","DOI":"10.1017\/S003329172000029X"},{"key":"S0033291724003507_r35","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-14-138"},{"key":"S0033291724003507_r64","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2009.04.007"},{"key":"S0033291724003507_r6","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-199703000-00012"},{"key":"S0033291724003507_r18","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30048-3"},{"key":"S0033291724003507_r21","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2016.01.081"},{"key":"S0033291724003507_r57","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-021-01526-0"},{"key":"S0033291724003507_r1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291720002226"},{"key":"S0033291724003507_r16","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2015.02.022"},{"key":"S0033291724003507_r47","doi-asserted-by":"publisher","DOI":"10.1177\/0269881115622241"},{"key":"S0033291724003507_r51","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/18.2.319"},{"key":"S0033291724003507_r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2021.09.016"},{"key":"S0033291724003507_r22","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbz077"},{"key":"S0033291724003507_r29","doi-asserted-by":"publisher","DOI":"10.1007\/s11065-019-09422-7"},{"key":"S0033291724003507_r4","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30057-9"},{"key":"S0033291724003507_r25","doi-asserted-by":"publisher","DOI":"10.1037\/h0031619"},{"key":"S0033291724003507_r52","doi-asserted-by":"publisher","DOI":"10.1093\/ijnp\/pyab014"},{"key":"S0033291724003507_r53","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbx126"},{"key":"S0033291724003507_r73","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbw177"},{"key":"S0033291724003507_r61","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.109118"},{"key":"S0033291724003507_r8","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291718003409"},{"key":"S0033291724003507_r75","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291719002319"},{"key":"S0033291724003507_r54","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13158"},{"key":"S0033291724003507_r62","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2015.07.084"},{"key":"S0033291724003507_r70","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2016.02.032"},{"key":"S0033291724003507_r74","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbs050"},{"key":"S0033291724003507_r26","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2013.269"},{"key":"S0033291724003507_r42","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-004-0803-z"},{"key":"S0033291724003507_r11","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2019.09.006"},{"key":"S0033291724003507_r38","doi-asserted-by":"publisher","DOI":"10.3923\/jas.2013.1251.1255"},{"key":"S0033291724003507_r49","doi-asserted-by":"publisher","DOI":"10.1007\/s40429-021-00404-5"},{"key":"S0033291724003507_r72","doi-asserted-by":"publisher","DOI":"10.1037\/neu0000367"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0033291724003507","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T06:43:34Z","timestamp":1738737814000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0033291724003507\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":80,"alternative-id":["S0033291724003507"],"URL":"https:\/\/doi.org\/10.1017\/s0033291724003507","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"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.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e12"}}