Hoff A L, Sakuma M, Razi K, Heydebrand G, Csernansky J G, DeLisi L E
Department of Psychiatry and Behavioral Sciences, State University of New York at Stony Brook, NY 11794, USA.
Am J Psychiatry. 2000 Nov;157(11):1824-8. doi: 10.1176/appi.ajp.157.11.1824.
The purpose of the study was to determine whether the duration of illness before antipsychotic drug treatment for schizophrenia was associated with the severity of cognitive deficits and volumetric brain structure anomalies observed in some patients with a first episode of schizophrenia.
Duration of psychotic symptoms and of other symptoms marking a behavioral change was estimated from structured interviews with 50 patients who had a first episode of schizophrenia and their family members. Interviews were conducted within a month of the patients' hospitalization. Duration of untreated psychotic symptoms and of behavioral change was correlated with neuropsychological summary scores from a comprehensive cognitive battery and with measurements of lateral ventricular, temporal lobe, and cerebral hemispheric volumes.
No significant correlations were observed between measures of untreated illness and the severity of either cognitive or structural brain deficits at baseline.
The duration of untreated symptoms of schizophrenia, for which an association with an uncontrolled toxic brain process has been proposed, is unlikely to explain why first-episode patients with schizophrenia have widespread deficits in cognitive functioning and have detectable ventricular enlargement and some loss of cortical mass.
本研究旨在确定精神分裂症患者在接受抗精神病药物治疗前的患病时长是否与首次发作的部分精神分裂症患者所观察到的认知缺陷严重程度及脑结构体积异常有关。
通过对50例首次发作的精神分裂症患者及其家庭成员进行结构化访谈，评估精神病性症状及其他标志行为改变的症状的持续时间。访谈在患者住院一个月内进行。未治疗的精神病性症状和行为改变的持续时间与综合认知测试电池的神经心理学总结分数以及侧脑室、颞叶和大脑半球体积的测量结果相关。
在基线时，未治疗疾病的测量指标与认知或脑结构缺陷的严重程度之间未观察到显著相关性。
精神分裂症未治疗症状的持续时间曾被认为与未受控制的毒性脑过程有关，但这一持续时间不太可能解释为何首次发作的精神分裂症患者存在广泛的认知功能缺陷、可检测到的脑室扩大以及部分皮质质量损失。
