Joint Doctoral Program in Clinical Psychology, San Diego State University.
Department of Psychiatry, University of California.
Neuropsychology. 2010 Jan;24(1):109-120. doi: 10.1037/a0016791.
Understanding the trajectory of cognitive changes in the development of schizophrenia may shed light on the neurodevelopmental processes in the beginning stage of illness. Subjects at risk for psychosis (AR, n = 48), patients in their first episode of schizophrenia (FE, n = 20), and normal comparison subjects (n = 29) were assessed on a neurocognitive battery at baseline and at a 6-month follow-up. There were significant group differences across all cognitive domains as well as a significant group by time interaction in the verbal learning domain. After statistically controlling for practice effects and regression to the mean, a high proportion of FE subjects showed an improvement in verbal learning, and a significant number of AR subjects improved in general intelligence. Moreover, a higher than expected percentage of FE subjects, as well as AR subjects who later converted to psychosis, showed a deterioration in working memory and processing speed. These inconsistent trajectories suggest that some domains may improve with stabilization in the early stages of psychosis, whereas others may decline with progression of the illness, indicating possible targets for cognitive remediation strategies and candidate vulnerability markers for future psychosis.
了解精神分裂症发展过程中认知变化的轨迹，可能有助于揭示疾病早期的神经发育过程。对处于精神病高危状态的受试者（AR，n=48）、首发精神分裂症患者（FE，n=20）和正常对照组受试者（n=29）进行了神经认知测试，分别在基线和 6 个月随访时进行评估。所有认知领域均存在显著的组间差异，言语学习领域存在显著的组间和时间交互作用。在对练习效应和向均数回归进行统计学控制后，大量 FE 患者的言语学习能力得到改善，大量 AR 患者的一般智力得到改善。此外，FE 患者中有高于预期的比例，以及以后转为精神病的 AR 患者，其工作记忆和处理速度都出现了恶化。这些不一致的轨迹表明，在精神病的早期阶段，某些领域可能会随着病情的稳定而改善，而其他领域可能会随着病情的进展而下降，这表明可能需要认知矫正策略，以及未来精神病的候选脆弱性标志物。
