Bartók Eniko, Berecz Roland, Glaub Theodóra, Degrell István
Department of Psychiatry, Medical and Health Science Centre, University of Debrecen, 98, Nagyerdei krt. H-4012, Debrecen, Hungary.
Prog Neuropsychopharmacol Biol Psychiatry. 2005 May;29(4):621-5. doi: 10.1016/j.pnpbp.2005.01.008.
Cognitive dysfunctions are now widely understood as an essential feature of schizophrenia. A great number of cognitive disturbances have been described in drug-naive first-episode patients as well. The full-blown psychotic symptoms are usually preceded by a longer prodromal period, in which non-specific psychological disturbances are already present. The late prodromal phase is also coined as the prepsychotic state, with attenuated, isolated psychotic symptoms. The aim of the present study was to detect cognitive dysfunctions among young adults at the prepsychotic stage with the use of a standardized computer based cognitive test battery.
Eleven (9 men, 2 women) young Hungarian adults referred to the Outpatient Clinic of the Department of Psychiatry at the University of Debrecen were studied. The patients were re-evaluated for psychotic symptoms after 12 months. The patients had no history of psychiatric disorders or psychotic episodes and were referred by general practitioners on account of non-specific emotional or behavioural abnormalities. The subjects were asked to perform a series of 13 computerized neuropsychological tests of the Cambridge Neuropsychological Test. The performance of the patients were compared to that of the standardized database of the Cambridge Neuropsychological Test.
The performance of the prepsychotic patients was significantly lower compared to the healthy individuals in the paired associate learning (PAL, p<0.001), Spatial recognition memory (SRM, p<0.05), Rapid visual processing (RVP, p<0.05), and Spatial working memory (SWM, p<0.05) tests.
Cognitive deficits were found mainly in attentional, frontal and prefrontal cognitive functions. These impairments may be present at the early stages of the development of psychosis and the standardized cognitive test battery (CANTAB) might be a useful tool for the detection of early cognitive impairments and provide a rationale for early intervention in individuals at risk of developing psychosis.
认知功能障碍如今被广泛认为是精神分裂症的一个基本特征。大量认知障碍在未服用药物的首发患者中也有描述。全面的精神病性症状通常之前有一个较长的前驱期，在此期间非特异性心理障碍已经存在。前驱期后期也被称为精神病前状态，伴有减弱的、孤立的精神病性症状。本研究的目的是使用标准化的基于计算机的认知测试组合来检测处于精神病前阶段的年轻成年人中的认知功能障碍。
对转介到德布勒森大学精神病学系门诊的11名（9名男性，2名女性）匈牙利年轻成年人进行了研究。12个月后对患者的精神病性症状进行了重新评估。这些患者没有精神疾病或精神病发作史，因非特异性情绪或行为异常由全科医生转介而来。受试者被要求进行一系列13项剑桥神经心理测试的计算机化神经心理学测试。将患者的表现与剑桥神经心理测试的标准化数据库进行比较。
在配对联想学习（PAL，p<0.001）、空间识别记忆（SRM，p<0.05）、快速视觉处理（RVP，p<0.05）和空间工作记忆（SWM，p<0.05）测试中，精神病前患者的表现与健康个体相比显著更低。
认知缺陷主要存在于注意力、额叶和前额叶认知功能中。这些损害可能在精神病发展的早期阶段就已出现，标准化的认知测试组合（CANTAB）可能是检测早期认知损害的有用工具，并为对有患精神病风险的个体进行早期干预提供依据。
