Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA.
Psychol Med. 2013 Dec;43(12):2535-45. doi: 10.1017/S0033291713000536. Epub 2013 Mar 25.
BACKGROUND: Cognition is increasingly being recognized as an important aspect of psychotic disorders and a key contributor to functional outcome. In the past, comparative studies have been performed in schizophrenia and schizo-affective disorder with regard to cognitive performance, but the results have been mixed and the cognitive measures used have not always assessed the cognitive deficits found to be specific to psychosis. A set of optimized cognitive paradigms designed by the Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia (CNTRACS) Consortium to assess deficits specific to schizophrenia was used to measure cognition in a large group of individuals with schizophrenia and schizo-affective disorder. METHOD: A total of 519 participants (188 with schizophrenia, 63 with schizo-affective disorder and 268 controls) were administered three cognitive paradigms assessing the domains of goal maintenance in working memory, relational encoding and retrieval in episodic memory and visual integration. RESULTS: Across the three domains, the results showed no major quantitative differences between patient groups, with both groups uniformly performing worse than healthy subjects. CONCLUSIONS: The findings of this study suggests that, with regard to deficits in cognition, considered a major aspect of psychotic disorder, schizophrenia and schizo-affective disorder do not demonstrate major significant distinctions. These results have important implications for our understanding of the nosological structure of major psychopathology, providing evidence consistent with the hypothesis that there is no natural distinction between cognitive functioning in schizophrenia and schizo-affective disorder.
背景:认知功能越来越被认为是精神疾病的一个重要方面,也是功能结局的一个关键决定因素。过去,人们已经针对精神分裂症和分裂情感性障碍进行了认知表现方面的比较研究,但是结果不一,而且所使用的认知测量方法并不总是评估到与精神病特异性相关的认知缺陷。一套由认知神经科学测试可靠性和精神分裂症临床应用(CNTRACS)联盟设计的优化认知范式,旨在评估精神分裂症特异性缺陷,用于测量一大群精神分裂症和分裂情感性障碍患者的认知功能。
方法:共有 519 名参与者(188 名精神分裂症患者、63 名分裂情感性障碍患者和 268 名对照者)接受了三个认知范式的测试,评估工作记忆中的目标维持、情景记忆中的关系编码和提取以及视觉整合等领域的认知功能。
结果:在这三个领域中,结果显示患者组之间没有明显的定量差异,两组的表现均明显差于健康受试者。
结论:这项研究的结果表明,在认知缺陷方面,被认为是精神疾病的一个主要方面,精神分裂症和分裂情感性障碍并没有表现出明显的显著区别。这些结果对我们理解主要精神病理学的分类结构具有重要意义,为认知功能在精神分裂症和分裂情感性障碍之间没有自然区别的假说提供了证据。