Thomas Gualtieri C
Dr. Gualtieri is the Medical Director at North Carolina Neuropsychiatry, PA, in Chapel Hill, North Carolina, and can be reached at
Psychiatry (Edgmont). 2004 Sep;1(2):29-36.
PSYCHIATRISTS SHOULD REVISIT THE ISSUE OF HOW TO ASSESS, OBJECTIVELY AND reliably, patients' cognitive status. Cognitive disorders, like ADHD (attention deficit/ hyperactivity disorder), and the various dementias are increasing in importance, and perhaps in number. The modern study of schizophrenia has focused on cognition as an outcome predictor; even the mood disorders can be associated, over time, with cognitive impairment. And with so many perfectly good drug alternatives in every therapeutic category, medications might be differentiated by virtue of their comparative effects on cognition. The best reason, however, is this: in clinical practice, cognitive assessment is either gross and insensitive or arduous and inordinately expensive.
精神科医生应重新审视如何客观且可靠地评估患者认知状态这一问题。认知障碍,如注意力缺陷多动障碍(ADHD)以及各类痴呆症,其重要性日益凸显,数量或许也在增加。现代对精神分裂症的研究聚焦于认知作为预后预测指标;随着时间推移,甚至情绪障碍也可能与认知损害相关。而且在每个治疗类别中都有诸多非常有效的药物选择,药物或许可依据其对认知的比较效果来加以区分。然而,最佳理由是:在临床实践中,认知评估要么粗略且不敏感,要么艰巨且成本过高。