Rhinewine Joseph P, Lencz Todd, Thaden Emily P, Cervellione Kelly L, Burdick Katherine E, Henderson Inika, Bhaskar Shree, Keehlisen Lynda, Kane John, Kohn Nina, Fisch Gene S, Bilder Robert M, Kumra Sanjiv
Department of Psychiatry Research Zucker Hillside Hospital, Glen Oaks, New York 11004, USA.
Biol Psychiatry. 2005 Nov 1;58(9):705-12. doi: 10.1016/j.biopsych.2005.04.031. Epub 2005 Jul 14.
Neurocognitive impairments have been documented in adolescents with early-onset schizophrenia (EOS; onset by age 18) and are important treatment targets. Information concerning the severity, pattern, and clinical correlates of these deficits in EOS remains limited.
Tests assessing motor skills, attention, memory, visuospatial abilities and executive functioning were administered to 54 clinically stabilized adolescents with EOS and 52 age- and sex-matched healthy controls. Childhood-onset patients (onset by age 13) were compared to those with an adolescent onset of illness. Patients' neurocognitive profiles were compared to those of controls. Relationships between neurocognitive deficits and demographic and clinical characteristics were explored.
Neurocognitive profiles did not differ between childhood- and adolescent-onset participants. Patients showed a generalized neurocognitive deficit of 2.0 SDs compared to controls, with relative deficit in executive functioning and relative sparing of language and visuospatial abilities. Degree of generalized neurocognitive impairment was associated with premorbid adjustment and negative symptom severity (Adjusted R(2) = .39).
Results document both a significant generalized deficit and a relative deficit of executive functioning in adolescents with EOS. The overall pattern is similar to that observed in severely ill first-episode adult patients. The impairments across multiple neurocognitive domains suggest widespread brain dysfunction in EOS.
早发性精神分裂症（EOS；18岁前发病）青少年存在神经认知障碍，这已得到证实，且是重要的治疗靶点。关于EOS中这些缺陷的严重程度、模式及临床相关性的信息仍然有限。
对54名临床症状稳定的EOS青少年和52名年龄及性别匹配的健康对照者进行了评估运动技能、注意力、记忆力、视觉空间能力和执行功能的测试。将儿童期起病患者（13岁前发病）与青少年期起病患者进行比较。将患者的神经认知概况与对照者的进行比较。探讨了神经认知缺陷与人口统计学和临床特征之间的关系。
儿童期起病和青少年期起病参与者的神经认知概况没有差异。与对照者相比，患者表现出2.0个标准差的广泛性神经认知缺陷，执行功能存在相对缺陷，语言和视觉空间能力相对保留。广泛性神经认知损害程度与病前适应和阴性症状严重程度相关（调整后R² = 0.39）。
结果证明EOS青少年既存在显著的广泛性缺陷，也存在执行功能的相对缺陷。总体模式与在重症首发成年患者中观察到的相似。多个神经认知领域的损害表明EOS存在广泛的脑功能障碍。
