Adelphi Values, Adelphi Mill, Bollington, Cheshire, UK.
Adv Ther. 2012 Feb;29(2):148-62. doi: 10.1007/s12325-012-0001-4. Epub 2012 Feb 10.
Nearly every individual with schizophrenia is affected by cognitive decline. The aim of this literature review was to: (a) describe the humanistic burden of cognitive impairment associated with schizophrenia (CIAS); (b) develop a conceptual model that depicts the signs and symptoms of CIAS along with key concepts important to patients; and (c) consider the adequacy of potential patient-reported outcome (PRO) instruments for assessing future treatments.
The following electronic databases were searched for articles published between January 1999 and November 2009 related to CIAS and PROs, or cost of illness: Medline; Embase; PsycINFO; the Health Economic Evaluation Database; and the National Health Service Economic Evaluation Database and Health Technology Assessment databases at the Centre for Reviews and Dissemination, University of York.
The literature search revealed 3950 abstracts, of which 101 articles were reviewed in detail. Cognitive functions affected include memory, attention/concentration, problem solving, learning, executive function, processing speed, and social cognition. Cognitive impairment impacts the ability of individuals to carry out activities of daily living, work productively, function socially, and adhere to treatment. These effects have economic ramifications through increased direct and indirect costs associated with the treatment of schizophrenia. The literature revealed 39 PRO instruments that have been used to assess functioning. However, no single instrument captures all key concepts of importance to patients with schizophrenia.
The significant burden from CIAS for patients and society has implications for designing future treatments and health strategies to improve functional outcomes.
几乎每个精神分裂症患者都受到认知能力下降的影响。本文综述的目的是：(a)描述与精神分裂症相关的认知障碍（CIAS）的人文负担；(b) 构建一个概念模型，描述 CIAS 的体征和症状，以及对患者重要的关键概念；并(c) 考虑潜在的患者报告结局（PRO）工具评估未来治疗的充分性。
检索了 1999 年 1 月至 2009 年 11 月期间发表的与 CIAS 和 PRO 或疾病成本相关的电子数据库中的文章：Medline；Embase；PsycINFO；卫生经济评价数据库；约克大学评论传播中心的国家卫生服务经济评价数据库和卫生技术评估数据库。
文献检索显示有 3950 个摘要，其中 101 篇文章进行了详细审查。受影响的认知功能包括记忆、注意力/集中、解决问题、学习、执行功能、处理速度和社会认知。认知障碍影响个人进行日常生活活动、高效工作、社交和坚持治疗的能力。这些影响通过与治疗精神分裂症相关的直接和间接成本增加而产生经济影响。文献中发现了 39 种用于评估功能的 PRO 工具。然而，没有单一的工具可以捕捉到对精神分裂症患者重要的所有关键概念。
CIAS 给患者和社会带来的巨大负担对设计未来的治疗和健康策略以改善功能结果具有重要意义。
