Riedel M, Schennach-Wolff R, Musil R, Dehning S, Cerovecki A, Opgen-Rhein M, Matz J, Seemüller F, Obermeier M, Engel R R, Müller N, Möller H-J, Spellmann I
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany.
Hum Psychopharmacol. 2010 Mar;25(2):116-25. doi: 10.1002/hup.1101.
To examine influencing variables of neurocognition in patients with schizophrenia and to predict cognition during antipsychotic treatment.
Data were obtained from patients with an acute episode of schizophrenia participating in two double-blind and one open label trial comparing the effects of different atypical antipsychotics on cognition. In total, 129 patients were enrolled in this analysis. Cognitive function was assessed at admission, week 4 and 8. Efficacy and tolerability were assessed weekly using the Positive and Negative Syndrome Scale (PANSS) and the Simpson Angus Sale (SAS). Patients were treated with aripirazole, olanzapine, quetiapine and risperidone. Regression analysis including mixed effect models was performed.
A significant improvement in all cognitive domains was observed from baseline to week 8. Regarding the antipsychotic treatment applied quetiapine seemed to achieve the most favourable cognitive improvement. Negative and depressive symptoms, the patient's age and the concomitant and antipsychotic treatment applied were observed to significantly influence and predict neurocognition.
The results may indicate that schizophrenia is a static disorder with trait and state dependent cognitive components especially in the memory domains. The influence of negative and depressive symptoms should be considered in daily clinical routine.
研究精神分裂症患者神经认知的影响变量，并预测抗精神病治疗期间的认知情况。
数据来自参与两项双盲试验和一项开放标签试验的精神分裂症急性发作患者，这些试验比较了不同非典型抗精神病药物对认知的影响。本分析共纳入129例患者。在入院时、第4周和第8周评估认知功能。每周使用阳性和阴性症状量表（PANSS）和辛普森·安格斯量表（SAS）评估疗效和耐受性。患者接受阿立哌唑、奥氮平、喹硫平和利培酮治疗。进行了包括混合效应模型的回归分析。
从基线到第8周，所有认知领域均有显著改善。就应用的抗精神病治疗而言，喹硫平似乎取得了最有利的认知改善。观察到阴性和抑郁症状、患者年龄以及应用的联合和抗精神病治疗对神经认知有显著影响并可进行预测。
结果可能表明，精神分裂症是一种具有特质和状态依赖性认知成分的静态疾病，尤其是在记忆领域。在日常临床工作中应考虑阴性和抑郁症状的影响。
