Departamento de Neurociencia, Sección de Psiquiatría, Facultad de Medicina y Odontología, Universidad del País Vasco (UPV-EHU), Vizcaya, España; Salud Mental CIBER-SAM, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Ministerio de Sanidad, España.
Rev Psiquiatr Salud Ment. 2008 Dec;1(1):18-25. doi: 10.1016/S1888-9891(08)72512-6. Epub 2008 Dec 21.
To describe the course of cognitive functioning in first-episode psychosis and to determine possible differences in the degree and trajectory of cognitive deficits between schizophrenia and non-schizophrenia first-episode psychosis.
We assessed attention, working memory, and executive functioning in 57 patients with first-episode psychosis both at baseline and at 1-year of follow-up.
For the overall group, significant reductions were found in the percentage of omission and commission errors for the sustained attention task (p<0.001 and p=0.001, respectively), in the total time to complete the Stroop-I task (p<0.001), in the percentage of omission errors for the working memory task (p=0.001), and in the percentage of perseverative errors for the Wisconsin card sorting test (WCST; p<0.001), as well as a significant increase in the number of categories completed in the WCST (p<0.001). The remaining cognitive variables analyzed remained stable (4 of the 10 variables tested). The pattern of change was similar for patients with schizophrenia (n=20) and non-schizophrenia (n=37) in the areas of attention and working memory. For executive functioning, the non-schizophrenia group showed a more beneficial pattern of change. No significant differences were detected in cognitive performance among subgroups at baseline or at the 1-year follow-up.
The course of cognitive deficits in first-episode psychosis showed significant improvements over the 1-year period in the areas of attention, working memory and executive functioning. Neuropsychological performance did not seem to be specific enough to distinguish between patients with schizophrenia and non-schizophrenia first-episode psychosis, at least during the first year.
描述首发精神病患者认知功能的变化过程，并确定精神分裂症和非精神分裂症首发精神病患者认知缺陷的程度和轨迹是否存在差异。
我们在基线和 1 年随访时评估了 57 例首发精神病患者的注意力、工作记忆和执行功能。
对于总体组，在维持注意力任务的错误率（持续错误率和遗漏错误率）（p<0.001 和 p=0.001）、Stroop-I 任务的总完成时间（p<0.001）、工作记忆任务的遗漏错误率（p=0.001）和威斯康星卡片分类测试（WCST）的持续错误率（p<0.001）显著降低，以及 WCST 完成的分类数显著增加（p<0.001）。分析的其余认知变量保持稳定（测试的 10 个变量中有 4 个）。在注意力和工作记忆方面，精神分裂症（n=20）和非精神分裂症（n=37）患者的变化模式相似。对于执行功能，非精神分裂症组的变化模式更为有利。在基线或 1 年随访时，亚组之间的认知表现没有差异。
首发精神病患者的认知缺陷在 1 年内得到显著改善，在注意力、工作记忆和执行功能方面有所改善。神经心理学表现似乎不够特异，无法区分精神分裂症和非精神分裂症首发精神病患者，至少在第一年是如此。
