Department of Psychiatry, University of Illinois Medical Center, Chicago, Ill 60612, USA.
Compr Psychiatry. 2010 Sep-Oct;51(5):471-9. doi: 10.1016/j.comppsych.2010.02.005. Epub 2010 Mar 29.
Individuals with schizophrenia have relative deficits in cognition, although little is known regarding the course of such deficits across the life span and at various stages of the illness. Furthermore, the relationship between psychosis and cognition has not been adequately explored to this point. Prospective, longitudinal, multi-assessment studies of the same patients across time are rare in the field and provide a unique opportunity to examine long-term changes in cognition among individuals with schizophrenia. As part of The Chicago Follow-up Study, we prospectively assessed 244 psychiatric inpatients, including individuals with schizophrenia, other psychotic disorders, and nonpsychotic depression. Assessments were conducted 7 times (once at index hospitalization and then 6 times subsequently for the next 20 years) to provide longitudinal data about cognition and symptoms, with a focus on 2 aspects of cognition: processing speed and the ability to access general knowledge. The Digit Symbol-Coding and Information subtests from the Wechsler Adult Intelligence scale were used to measure the 2 cognitive domains at each assessment. At all 7 assessments, individuals with schizophrenia performed more poorly than the other diagnostic groups on the 2 cognitive measures. However, after the acute phase (index hospitalization), individuals with schizophrenia demonstrated significant improvements in cognition and did not show evidence of cognitive decline over the remaining 6 assessments spanning 20 years. Our data support the presence of relative cognitive impairment in schizophrenia, as well as a pattern of stability in some cognitive areas after the acute phase. In addition, we find evidence for an association between relative cognitive impairment and psychosis.
个体患有精神分裂症时认知能力会相对下降，尽管对于认知缺陷在整个生命周期和疾病的各个阶段的发展过程知之甚少。此外，到目前为止，还没有充分探索精神分裂症与认知之间的关系。对同一患者进行跨时间、多评估的前瞻性纵向研究在该领域非常罕见，为研究精神分裂症患者认知能力的长期变化提供了独特的机会。作为芝加哥后续研究的一部分，我们前瞻性地评估了 244 名精神病住院患者，包括精神分裂症患者、其他精神病患者和非精神病性抑郁症患者。共进行了 7 次评估（首次在索引住院期间，然后在接下来的 20 年内进行 6 次评估），以提供关于认知和症状的纵向数据，重点关注认知的 2 个方面：处理速度和获取一般知识的能力。韦氏成人智力量表的数字符号编码和信息测验用于在每次评估中测量这 2 个认知领域。在所有 7 次评估中，精神分裂症患者在这 2 项认知测试中的表现均不如其他诊断组。然而，在急性阶段（索引住院）之后，精神分裂症患者的认知能力显著提高，并且在接下来的 6 次评估中（跨越 20 年）没有表现出认知能力下降的迹象。我们的数据支持精神分裂症存在相对认知障碍，以及急性阶段后某些认知领域稳定的模式。此外，我们还发现相对认知障碍与精神病之间存在关联的证据。
