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精神分裂症青少年的神经认知缺陷:纵向稳定性及对短期功能结局的预测效用

Neurocognitive deficits in adolescents with schizophrenia: longitudinal stability and predictive utility for short-term functional outcome.

作者信息

Cervellione Kelly L, Burdick Katherine E, Cottone John G, Rhinewine Joseph P, Kumra Sanjiv

机构信息

Department of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY 11004, USA.

出版信息

J Am Acad Child Adolesc Psychiatry. 2007 Jul;46(7):867-78. doi: 10.1097/chi.0b013e318054678d.

Abstract

OBJECTIVE

Previous cross-sectional studies in adolescents with early-onset schizophrenia (EOS; onset of psychotic symptoms by 18 years of age) have reported patterns of generalized neurocognitive deficits as compared to healthy comparison subjects (HCSs). Here, the authors examined the longitudinal stability of neuropsychological deficits in adolescents with EOS relative to HCS and the associations of these deficits with short-term functional outcome in patients.

METHOD

Fifty-two subjects (26 EOS, 26 HCS) were evaluated using a comprehensive neuropsychological test battery a median of 13 months after baseline examination. The stability of scores and the relationship between baseline test performance and functional outcome in patients was explored.

RESULTS

Adolescents with EOS were impaired across neurocognitive domains at baseline and follow-up compared to HCSs; these deficits remained relatively stable over time. Follow-up social/communication, personal living, and community living skills were significantly related to attention/vigilance, working memory and verbal memory at baseline; individual cognitive domains were more strongly related to functional outcome than a global measure of intelligence.

CONCLUSIONS

Neuropsychological impairment in patients with EOS appears to remain relatively stable over time regardless of changes in clinical state. In addition, this report offers preliminary support for a longitudinal relationship between neurocognitive performance in specific domains and functional outcome.

摘要

目的

以往针对早发性精神分裂症(EOS,即18岁前出现精神病性症状)青少年的横断面研究报告称,与健康对照受试者(HCS)相比,这类患者存在广泛性神经认知缺陷模式。在此,作者研究了EOS青少年相对于HCS的神经心理学缺陷的纵向稳定性,以及这些缺陷与患者短期功能结局的关联。

方法

52名受试者(26名EOS患者,26名HCS)在基线检查后中位数13个月时使用一套全面的神经心理学测试组进行评估。探讨了患者得分的稳定性以及基线测试表现与功能结局之间的关系。

结果

与HCS相比,EOS青少年在基线和随访时的各个神经认知领域均受损;随着时间推移,这些缺陷保持相对稳定。随访时的社交/沟通、个人生活和社区生活技能与基线时的注意力/警觉性、工作记忆和言语记忆显著相关;与整体智力测量相比,各个认知领域与功能结局的相关性更强。

结论

无论临床状态如何变化,EOS患者的神经心理学损害似乎随时间推移保持相对稳定。此外,本报告为特定领域的神经认知表现与功能结局之间的纵向关系提供了初步支持。

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