Benaiges Irina, Serra-Grabulosa Josep Maria, Prat Gemma, Adan Ana
Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain.
Hum Psychopharmacol. 2013 Jan;28(1):29-39. doi: 10.1002/hup.2279. Epub 2012 Nov 20.
Although little is known about neurocognition in Dual Diagnosis, it has been suggested that Schizophrenia (SZ) patients with comorbid substance use belong to a subgroup with lower genetic vulnerability to develop SZ and, consequently, they show better executive and social premorbid functioning. The first aim of this study was to assess the executive functioning, and the second one was to explore the effect of age of onset of substance use in neurocognition in SZ patients with cocaine dependence.
The total sample consisted of 95 male patients, aged 20 to 60 years, divided in three groups: one group with SZ and cocaine dependence (SZ+; n = 30), another group with SZ without cocaine dependence (SZ-; n = 30), and a control group with cocaine dependence without psychiatric comorbidity (COC; n = 35).
We found a better executive functioning in both SZ+ and COC than SZ-. We observed a worse performance of SZ+ patients compared with COC in cognitive set-shifting regardless the age of onset of consumption.
The results agree with the hypothesis of a lower genetic vulnerability in SZ+ patients to develop psychosis compared with SZ-, who develop it without any additional trigger. However, future research is needed to clarify the current knowledge gaps.
尽管对双重诊断中的神经认知了解甚少，但有研究表明，合并物质使用的精神分裂症（SZ）患者属于遗传易感性较低的亚组，因此，他们在病前表现出更好的执行功能和社交功能。本研究的首要目的是评估执行功能，第二个目的是探讨物质使用起始年龄对可卡因依赖的SZ患者神经认知的影响。
总样本包括95名年龄在20至60岁之间的男性患者，分为三组：一组为患有SZ且有可卡因依赖的患者（SZ+；n = 30），另一组为患有SZ但无可卡因依赖的患者（SZ-；n = 30），以及一组有可卡因依赖但无精神疾病共病的对照组（COC；n = 35）。
我们发现SZ+组和COC组的执行功能均优于SZ-组。无论消费起始年龄如何，我们观察到SZ+组患者在认知转换方面的表现均不如COC组。
结果支持这样的假设，即与无任何额外诱因就发病的SZ-组患者相比，SZ+组患者发生精神病的遗传易感性较低。然而，需要进一步的研究来填补当前的知识空白。
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