Department of Psychiatry, Alava University Hospital-Santiago, Department of Neurosciences, University of the Basque Country, CIBERSAM, Vitoria, Spain.
Psychiatry Res. 2013 Mar 30;206(1):8-16. doi: 10.1016/j.psychres.2012.08.025. Epub 2012 Sep 15.
The relationship of neurocognitive course with clinical and functional outcomes in psychosis is not well known, especially in the long term. The aim of the study was to examine the clinical and neuropsychological course of first-episode psychosis patients at 5-year follow-up and analyze the relationship of cognitive performance with clinical and functional outcome. The 5-year follow-up was conducted with 26 first-episode psychosis patients. Psychotic symptoms were measured by the Positive and Negative Syndrome Scale, manic and depressive symptoms by the Young Mania Rating Scale and Hamilton Depression Rating Scale respectively, and psychosocial functioning by the Functioning Assessment Short Test. The cognitive domains were assessed by the Wechsler Adult Intelligence Scale, the Wisconsin Card Sorting Test, the Trail Making Test, the Verbal Fluency Test, the Stroop Colour-Word Test and the Wechsler Memory Scale. Patients showed symptomatic improvement in the follow-up except in negative psychotic symptoms. There was also improvement in most cognitive domains except in working memory and processing speed in the follow-up. Working memory impairment was associated to negative psychotic symptoms and poor functional outcomes. Negative symptoms mediated the relationship between working memory and outcome. Therefore, negative symptoms should be a primary target of treatment to improve functional outcomes.
神经认知过程与精神病的临床和功能结局的关系尚不清楚，特别是在长期。本研究的目的是在 5 年的随访中检查首发精神病患者的临床和神经心理学过程，并分析认知表现与临床和功能结果的关系。对 26 例首发精神病患者进行了 5 年的随访。采用阳性和阴性症状量表（Positive and Negative Syndrome Scale）测量精神病症状，Young Mania Rating Scale 和 Hamilton Depression Rating Scale 分别测量躁狂和抑郁症状，Functioning Assessment Short Test 测量社会心理功能。采用韦氏成人智力量表（Wechsler Adult Intelligence Scale）、威斯康星卡片分类测验（Wisconsin Card Sorting Test）、连线测验（Trail Making Test）、词语流畅性测验（Verbal Fluency Test）、Stroop 色词测验（Stroop Colour-Word Test）和韦氏记忆量表（Wechsler Memory Scale）评估认知领域。除阴性精神病症状外，患者在随访中表现出症状改善。除工作记忆和处理速度外，大多数认知领域也有所改善。工作记忆障碍与阴性精神病症状和较差的功能结果相关。阴性症状介导了工作记忆和结果之间的关系。因此，阴性症状应该是改善功能结果的主要治疗目标。
