David Anthony S, Zammit Stanley, Lewis Glyn, Dalman Christina, Allebeck Peter
Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King's College, London, UK.
Schizophr Bull. 2008 Nov;34(6):1035-41. doi: 10.1093/schbul/sbn028. Epub 2008 Apr 25.
It is well established that cognitive deficits are an almost invariable component of the schizophrenia syndrome. Much less is known about the association of cognitive deficits and the range of psychiatric disorders. The current study made use of a Swedish conscript cohort which included an IQ assessment and full psychiatric evaluation at conscription of all 18- to 19-year-old males. It was found that reduced intellectual functioning was found in association with psychosis and neurotic disorders including depression, personality disorders, alcoholism, and drug dependence. The effect was particularly strong for alcoholism. This presumably represents a combination of premorbid deficits (as demonstrated in those who developed schizophrenia some years later) plus coincident impairments. The direction of causality of this latter association is likely to be both forward and reverse. Different cognitive subtests showed varied strengths of association: "mechanical ability/knowledge," which might reflect planning and reasoning more than the other subtests, had the strongest effect. Cognitive deficits are widespread in psychiatric disorders and should be taken into account in clinical interactions.
认知缺陷几乎始终是精神分裂症综合征的一个组成部分,这一点已得到充分证实。关于认知缺陷与一系列精神障碍之间的关联,人们了解得要少得多。当前的研究利用了一个瑞典应征入伍者队列,其中包括对所有18至19岁男性应征入伍时的智商评估和全面的精神评估。研究发现,智力功能下降与精神病和神经症性障碍有关,包括抑郁症、人格障碍、酗酒和药物依赖。这种影响在酗酒方面尤为强烈。这可能代表了病前缺陷(如几年后发展为精神分裂症的人所表现出的)与同时出现的损伤的综合作用。后一种关联的因果关系方向可能是双向的。不同的认知子测试显示出不同的关联强度:“机械能力/知识”,它可能比其他子测试更能反映计划和推理能力,其影响最为强烈。认知缺陷在精神障碍中普遍存在,在临床互动中应予以考虑。