Prouteau Antoinette, Verdoux Hélène, Briand Catherine, Lesage Alain, Lalonde Pierre, Nicole Luc, Reinharz Daniel, Stip Emmanuel
INSERM U657 & JE 2358, IFR of Public Health, University Victor Segalen Bordeaux 2, 146 rue Leo Saignat, 33076 Bordeaux Cedex, France.
Schizophr Res. 2005 Sep 15;77(2-3):343-53. doi: 10.1016/j.schres.2005.03.001.
The aims of this prospective study were to explore in subjects with psychosis participating in a rehabilitation program whether cognitive performances at baseline predicted (i) psychosocial functioning over a 15-16 month follow-up; (ii) improvement in psychosocial functioning over the rehabilitation program. Visuo-spatial tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were administered to assess cognitive performance in 55 subjects with schizophrenia spectrum disorders who completed a rehabilitation program. The Multnomah Community Ability Scale (MCAS) was used to measure dimensions of community functioning. One subscale of the Client's Assessment of Strengths, Interests, and Goals (CASIG) provided a measure of subjective quality of life (QoL). Improvement was defined as a 15% or more increase in psychosocial scores between baseline and follow-up. Worse baseline sustained attention predicted better self-rated quality of life, and better baseline visual memory predicted better community functioning over the rehabilitation follow-up period, in particular, higher autonomy in activities of daily living, and less physical and psychiatric symptoms that could interfere with rehabilitation. Baseline cognitive performances predicted community functioning improvement during the follow-up period: visual memory predicted improvement in daily living autonomy and in social competence; sustained attention predicted improvement in behavioral problems (such as medication compliance, collaboration with treatment providers or impulse control) and social competence; planning performances predicted improvement in social competence. These cognitive functions could be specifically targeted in a rehabilitation program aimed at enhancing functioning in those particular dimensions.
这项前瞻性研究的目的是，在参与康复项目的精神病患者中探究，基线时的认知表现是否能预测：（i）在15 - 16个月的随访期内的社会心理功能；（ii）在康复项目期间社会心理功能的改善情况。对55名完成康复项目的精神分裂症谱系障碍患者进行了剑桥神经心理测试自动成套系统（CANTAB）中的视觉空间测试，以评估其认知表现。使用摩特诺玛社区能力量表（MCAS）来衡量社区功能维度。服务对象优势、兴趣和目标评估量表（CASIG）的一个子量表用于衡量主观生活质量（QoL）。改善被定义为基线和随访之间社会心理得分增加15%或更多。基线时更差的持续性注意力预测了更好的自评生活质量，而更好的基线视觉记忆预测了在康复随访期内更好的社区功能，特别是在日常生活活动中有更高的自主性，以及更少的可能干扰康复的身体和精神症状。基线认知表现预测了随访期内社区功能的改善：视觉记忆预测了日常生活自主性和社交能力的改善；持续性注意力预测了行为问题（如服药依从性、与治疗提供者的合作或冲动控制）和社交能力的改善；计划能力预测了社交能力的改善。在旨在增强这些特定维度功能的康复项目中，可以专门针对这些认知功能。
