Ayres Adriana M, Busatto Geraldo F, Menezes Paulo R, Schaufelberger Maristela S, Coutinho Letícia, Murray Robin M, McGuire Philip K, Rushe Teresa, Scazufca Marcia
Department of Psychiatry, Universidade de São Paulo, São Paulo, Brazil.
Schizophr Res. 2007 Feb;90(1-3):338-43. doi: 10.1016/j.schres.2006.09.026. Epub 2006 Nov 22.
Studies conducted in high-income countries have reported significant cognitive deficits in first on set schizophrenia subjects relative to asymptotic controls, and it has been suggested that the severity of such deficits could be directly related to the duration of untreated psychosis (DUP). It is relevant to conduct similar studies in developing countries, given the supposedly better outcome for schizophrenia patients living in the latter environments.
We applied verbal fluency and digit span tests to an epidemiological-based series of patients with first-onset psychoses (n=179) recruited in the city of São Paulo, and compared the findings with those from non-psychotic control subjects randomly selected from the same geographical areas (n=383).
Psychosis subjects showed lower scores on the three tests relative to controls, with greatest between-group differences for the backward digit span task (p<0.0001). There were no significant differences between subjects with affective and schizophreniform psychosis. Cognitive performance indices were negatively correlated with the severity of negative symptoms, but showed no relation to DUP.
We found significant cognitive deficits in patients investigated early during the course of psychotic disorders in an environment that is distinct from those where the subjects investigated in previous studies have been drawn from. We found no support to the hypothesis of an association between greater cognitive deficits and a longer DUP.
在高收入国家进行的研究报告称，首发精神分裂症患者相对于症状稳定的对照组存在显著的认知缺陷，并且有人提出，这些缺陷的严重程度可能与未治疗精神病的持续时间（DUP）直接相关。鉴于生活在发展中国家的精神分裂症患者预后可能更好，在这些国家开展类似研究具有重要意义。
我们对在圣保罗市招募的一系列基于流行病学的首发精神病患者（n = 179）进行了语言流畅性和数字广度测试，并将结果与从同一地理区域随机选取的非精神病对照组受试者（n = 383）的结果进行比较。
与对照组相比，精神病患者在这三项测试中的得分较低，其中倒背数字广度任务的组间差异最大（p < 0.0001）。情感性精神病和精神分裂症样精神病患者之间没有显著差异。认知表现指数与阴性症状的严重程度呈负相关，但与DUP无关。
我们在一个与先前研究中所调查对象来源不同的环境中，发现了在精神病病程早期接受调查的患者存在显著的认知缺陷。我们没有找到证据支持认知缺陷越严重与DUP越长之间存在关联的假设。
