Hilda Picasso H L, Ostrosky F, Nicolini H
Laboratorio de Neuropsicología y Psicofisiología, Facultad de Psicología, UNAM, Mexico.
Actas Esp Psiquiatr. 2005 Mar-Apr;33(2):87-95.
Cognitive impairment is a prominent feature of schizophrenia that correlates with functional outcome. In the clinical practice and research, there is a need to count on brief, reliable and standardized instruments to evaluate the cognitive profile in psychiatric, geriatric and neurological patients. There are only a few standardized and validated instruments with the Hispanic population, so the adaptation and validation of instruments become a high relevance issue. The Brief Neuropsychological Test in Spanish (NEUROPSI) is a brief neuropsychological battery evaluating a wide spectrum of cognitive functions and standardized with Spanish speaking population according to age and educational level. The purpose of the present study was to determine the sensitivity and specificity of this instrument for its clinical use in patients with schizophrenia, as well as in distinct subtypes of schizophrenic patients: positive, negative and mixed.
We studied a total sample of 60 subjects (30 patients with schizophrenia and 30 matched controls). Using the total score we found 87.5 % sensitivity and 92.8% specificity. A discriminant analysis using the 25 subtest scores of the NEUROPSI accurately classified 83.3 % of the sample. None of the control subjects was classified as patient.
Classification by subtype showed 80 % of patients with negative symptoms, 90 % of patients with positive symptoms and 70 % of patients with mixed symptoms.
The accurate diagnosis of cognitive dysfunction in schizophrenic patients could help in management as well as development of more specific pharmacological treatment for each schizophrenic subtype.
认知障碍是精神分裂症的一个突出特征，与功能预后相关。在临床实践和研究中，需要依靠简短、可靠且标准化的工具来评估精神病、老年病和神经病患者的认知状况。针对西班牙裔人群的标准化且经过验证的工具很少，因此工具的改编和验证成为一个高度相关的问题。西班牙语简短神经心理测试（NEUROPSI）是一种简短的神经心理成套测试，可评估广泛的认知功能，并根据年龄和教育水平在讲西班牙语的人群中进行了标准化。本研究的目的是确定该工具在精神分裂症患者及其不同亚型（阳性、阴性和混合型）临床应用中的敏感性和特异性。
我们研究了总共60名受试者的样本（30名精神分裂症患者和30名匹配的对照组）。使用总分，我们发现敏感性为87.5%，特异性为92.8%。使用NEUROPSI的25个分测验分数进行的判别分析准确地将83.3%的样本分类。没有一名对照受试者被分类为患者。
按亚型分类显示，阴性症状患者占80%，阳性症状患者占90%，混合症状患者占70%。
准确诊断精神分裂症患者的认知功能障碍有助于管理以及为每种精神分裂症亚型开发更具针对性的药物治疗。
