Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands.
Psychol Med. 2010 Oct;40(10):1599-606. doi: 10.1017/S0033291710000048. Epub 2010 Feb 5.
Cognitive impairment is considered to be a core characteristic of schizophrenia. The relationship between psychosis and cognitive deterioration, however, remains unclear. This longitudinal study investigated the neuropsychological functioning of patients before and after their first psychotic episode. Cognitive functioning of participants who later developed a psychosis was compared to that of people at ultra-high risk (UHR) for psychosis who did not develop psychosis at follow-up and healthy controls.MethodParticipants were 41 persons at UHR for psychosis (the UHR group), of whom 17 developed psychosis between the first and second assessment. Seventeen healthy controls were included in the study. Cognitive performance was assessed at intake (T0) and again after 18 months (T1). The areas of cognitive functioning assessed include verbal memory and learning, visuospatial working memory, executive function, sustained attention and motor speed.
The transition group did not perform significantly worse at the second assessment than at the first on any of the outcome measures. The UHR group performed better on a verbal learning and memory test at T1 compared to T0. At T0, the control group scored significantly better than the UHR group and the transition group on the verbal learning and memory test and the verbal fluency test.
The results indicate that no cognitive deterioration occurs during the first psychotic episode. Problems in verbal memory may be present before the first episode of psychosis.
认知障碍被认为是精神分裂症的核心特征。然而,精神病和认知恶化之间的关系仍不清楚。本纵向研究调查了首次精神病发作前后患者的神经心理学功能。将后来发生精神病的参与者的认知功能与未在随访中发生精神病的超高危(UHR)人群的认知功能进行了比较,并与健康对照组进行了比较。
参与者为 41 名处于精神病超高危(UHR)的人群(UHR 组),其中 17 人在首次和第二次评估之间出现精神病。研究还纳入了 17 名健康对照组。在入组时(T0)和 18 个月后(T1)评估认知表现。评估的认知功能领域包括言语记忆和学习、视空间工作记忆、执行功能、持续注意力和运动速度。
在任何结果测量中,过渡组在第二次评估时的表现都不比第一次差。与 T0 相比,UHR 组在 T1 时在言语学习和记忆测试中表现更好。在 T0 时,与 UHR 组和过渡组相比,对照组在言语学习和记忆测试以及言语流畅性测试中的得分明显更高。
结果表明,在首次精神病发作期间没有发生认知恶化。在首次精神病发作之前,言语记忆可能存在问题。