Neurocognitive Deficits in Individuals at Ultra-High-Risk for Psychosis: An Overview of Systematic Reviews

Objective: Identifying individuals at ultra-high risk for psychosis (UHRP) is crucial for early intervention and prevention strategies. Neurocognitive deficits have been increasingly recognized as potential predictors of psychosis onset. This overview aims to consolidate current evidence and elucidate the role of neurocognitive predictors in identifying UHRP individuals. Method: we systematically searched three scientific databases, i.e., PubMed, Scopus, and Google Scholar using predefined keywords related to predictive neurocognitive markers and ultra-high risk psychosis. By following the PRISMA procedure, we included all relevant systematic-reviews and meta-analyses in our data-synthesis. Results: Neurocognitive deficits, including impairments in working memory, attentional control, verbal learning, and executive functions, have been consistently identified as predictors of psychosis conversion in individuals at UHRP. Structural and functional neuroimaging studies have further revealed aberrant brain connectivity, reduced gray matter volume, and altered neural activation patterns in key brain regions to be involved in psychosis. Moreover, the combination of neurocognitive and clinical risk factors has been shown to enhance the accuracy of predicting psychosis onset and inform personalized intervention strategies. Conclusion: Neurocognitive deficits serve as valuable predictors of the risk of psychosis in individuals with UHRP, offering insights into the underlying neurobiological mechanisms and potential targets for early intervention. Future research should focus on refining predictive models, elucidating the neurodevelopmental trajectories, and evaluating the efficacy of targeted interventions in mitigating the psychosis risk.