Department of Psychiatry, University of Naples SUN, Naples, Italy.
Schizophr Res. 2009 Dec;115(2-3):104-14. doi: 10.1016/j.schres.2009.09.022. Epub 2009 Oct 12.
Profile and correlates of cognitive deficits in first episode (FE) schizophrenia patients are still debated. The present study is aimed to clarify in a large sample of FE patients the extent of impairment in key cognitive domains and its relationships with demographic and clinical variables.
The European First Episode Schizophrenia Trial collected demographic, clinical and neurocognitive baseline data in 498 FE patients with minimal or no prior exposure to antipsychotics. Two-hundred-twenty healthy subjects (HS) were also evaluated. Neurocognitive assessment included the Rey Auditory Verbal Learning Test; Trail Making A and B, Purdue Pegboard and Digit-Symbol Coding.
Patients performed worse than HS on all tests (effect sizes from -0.88 to -1.73). Correlations with psychopathological dimensions were weak and involved reality distortion and disorganization. The duration of untreated psychosis (DUP) was not associated with cognitive impairment. Subjects living alone had a better neurocognitive performance, while the occupation status did not reveal any association with cognition.
A moderate/severe impairment of processing speed, motor dexterity, verbal memory and cognitive flexibility was found in the largest sample of FE patients analyzed so far. The impairment was largely independent from psychopathology and not associated with DUP.
首发精神分裂症患者认知缺陷的特征及其相关因素仍存在争议。本研究旨在对大量首发精神分裂症患者进行研究，以明确主要认知领域的损害程度及其与人口统计学和临床变量的关系。
欧洲首发精神分裂症试验（European First Episode Schizophrenia Trial）在最小或无抗精神病药物暴露的 498 名首发精神分裂症患者中收集了人口统计学、临床和神经认知基线数据。还对 220 名健康受试者（HS）进行了评估。神经认知评估包括 Rey 听觉言语学习测试；追踪 A 和 B、Purdue 钉板和数字符号编码。
患者在所有测试中均表现差于 HS（效应大小为-0.88 至-1.73）。与精神病理学维度的相关性较弱，涉及现实扭曲和混乱。未治疗的精神病持续时间（DUP）与认知障碍无关。独居者的神经认知表现较好，而职业状况与认知无关联。
在迄今为止分析的最大的首发精神分裂症患者样本中，发现了加工速度、运动灵巧性、言语记忆和认知灵活性的中度/严重损害。损害在很大程度上独立于精神病理学，与 DUP 无关。
