Laes JoAn R, Sponheim Scott R
Department of Psychiatry, University of Minnesota, 2450 Riverside Ave, Minneapolis, MN 55455 USA.
Schizophr Res. 2006 May;84(1):121-31. doi: 10.1016/j.schres.2005.11.023. Epub 2006 Jan 27.
Cognitive deficits predict functioning in schizophrenia; however, little is known as to whether the association is present in other mental disorders. If specific cognitive deficits uniquely predict functional impairment in schizophrenia the association of select aspects of brain dysfunction with daily living would suggest an intervention target and perhaps a means by which to improve the functioning of schizophrenia patients. The relationship of cognition and functioning was investigated in schizophrenia (n=39), bipolar affective disorder (n=27), and nonpsychiatric control (n=38) participants to determine whether the associations varied across groups. We examined verbal memory, verbal learning, verbal fluency, vigilance, executive functioning, symptomatology, and generalized cognitive functioning for associations with social function. Correlational analyses revealed particular cognitive domains (e.g., verbal memory) to be associated with social functioning in schizophrenia, bipolar, and control subjects; however generalized cognitive function and symptomatology were also associated with social functioning in patients. Multiple regression analyses revealed that in schizophrenia poor verbal memory predicted worse social functioning even after the effects of generalized cognitive dysfunction were considered. Verbal memory indices failed to account for variance in social function in bipolar patients and control subjects after consideration of generalized cognitive function. Bipolar patients with worse planning and problem solving tended to have worse social functioning. Therefore, unlike schizophrenia patients who may fail to process verbally mediated material, bipolar patients' difficulty with logical approaches to problems in daily living may have the greatest impact on their community function.
认知缺陷可预测精神分裂症患者的功能状况；然而，对于其他精神障碍中是否存在这种关联却知之甚少。如果特定的认知缺陷能独特地预测精神分裂症患者的功能损害，那么大脑功能障碍的某些特定方面与日常生活的关联将提示一个干预靶点，或许也是改善精神分裂症患者功能状况的一种方法。对39名精神分裂症患者、27名双相情感障碍患者和38名非精神科对照参与者的认知与功能之间的关系进行了研究，以确定这种关联在不同组之间是否存在差异。我们考察了言语记忆、言语学习、言语流畅性、警觉性、执行功能、症状学以及一般认知功能与社会功能之间的关联。相关性分析显示，在精神分裂症患者、双相情感障碍患者和对照受试者中，特定的认知领域（如言语记忆）与社会功能相关；然而，一般认知功能和症状学也与患者的社会功能相关。多元回归分析显示，在精神分裂症患者中，即使在考虑了一般认知功能障碍的影响之后，较差的言语记忆仍预示着较差的社会功能。在考虑了一般认知功能之后，言语记忆指标无法解释双相情感障碍患者和对照受试者社会功能的差异。计划和解决问题能力较差的双相情感障碍患者往往具有较差的社会功能。因此，与可能无法处理言语介导材料的精神分裂症患者不同，双相情感障碍患者在日常生活中采用逻辑方法解决问题的困难可能对其社区功能影响最大。
