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Abstract
Schizophrenia has been associated with deficits in visual perception and processing,
but there is little information about their temporal development and stability. We
assessed visual form perception using the Rorschach Comprehensive System (RCS) in
23 individuals at clinical high risk for psychosis, 15 individuals with recent onset
schizophrenia (< or =2 years since onset), and 34 with chronic schizophrenia (> or
=3 years since onset). All three groups demonstrated reduced conventional form perception
(X+%), as compared with published norms, but did not differ significantly from one
another. In contrast, the high-risk group had significantly better performance on
an index of clarity of conceptual thinking (WSUM6) compared to the chronic schizophrenia
patients, with the recent onset group scoring intermediate to the high-risk and chronic
schizophrenia groups. The results suggest that individuals at clinical high risk for
psychosis display substantial deficits in visual form perception prior to the onset
of psychosis and that these deficits are comparable in severity to those observed
in individuals with schizophrenia. Therefore, visual form perception deficits may
constitute a trait-like risk factor for psychosis in high-risk individuals and may
potentially serve as an endophenotype of risk for development of psychosis. Clarity
of conceptual thinking was relatively preserved among high-risk patients, consistent
with a relationship to disease expression, not risk. These deficits are discussed
in the context of the putative neurobiological underpinnings of visual deficits and
the developmental pathophysiology of psychosis in schizophrenia.