Burdick Katherine E, Gunawardane Nisali, Woodberry Kristen, Malhotra Anil K
Feinstein Institute for Medical Research, Center for Translational Psychiatry, Manhasset, New York, USA.
Cogn Neuropsychiatry. 2009;14(4-5):299-311. doi: 10.1080/13546800902805347.
Neurocognitive impairment is common to several neuropsychiatric disorders. The growing use of cognitive impairment as an intermediate phenotype, or "endophenotype", in psychiatry raises the issue of whether global measures of cognition, such as IQ, or assays of more specific cognitive domains, such as working memory, will best serve to enhance power in detecting susceptibility loci in molecular genetic studies.
This paper will review the research on general intelligence in schizophrenia and bipolar disorder and evaluate its strengths and weaknesses as a candidate intermediate phenotype.
Although global measures of cognition may not be optimal as intermediate phenotypes in bipolar disorder, certain clinical traits that overlap between schizophrenia and bipolar disorder, such as psychosis, may be predictive of poor performance on global measures, regardless of DSM-IV categorisation.
Global measures of cognition represent good intermediate phenotypes in schizophrenia. Current research does not support the use of global measures of cognition as intermediate phenotypes for bipolar disorder. Assays of specific neurocognitive domains may have greater potential to detect genetic markers for bipolar disorder.
神经认知障碍在多种神经精神疾病中很常见。在精神病学中,越来越多地将认知障碍用作中间表型或“内表型”,这就引发了一个问题,即诸如智商之类的整体认知测量方法,或者诸如工作记忆之类的更特定认知领域的检测方法,是否最有助于提高分子遗传学研究中检测易感基因座的效力。
本文将综述关于精神分裂症和双相情感障碍中一般智力的研究,并评估其作为候选中间表型的优缺点。
尽管整体认知测量方法作为双相情感障碍的中间表型可能并非最佳,但精神分裂症和双相情感障碍之间重叠的某些临床特征,如精神病性症状,可能预示着整体测量表现不佳,而与《精神疾病诊断与统计手册》第四版(DSM-IV)的分类无关。
整体认知测量方法在精神分裂症中是良好的中间表型。目前的研究不支持将整体认知测量方法用作双相情感障碍的中间表型。特定神经认知领域的检测方法在检测双相情感障碍的遗传标记方面可能具有更大潜力。