Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg University Hospital, Aalborg, Denmark.
Aust N Z J Psychiatry. 2013 Jul;47(7):637-45. doi: 10.1177/0004867413484093. Epub 2013 Apr 10.
To investigate the correlations between cognitive function and clinical outcome variables.
Patients diagnosed for the first time with schizophrenia between January 2004 and June 2010 were cognitively tested in conjunction with diagnostic procedures. Cognitive test data were connected to Danish healthcare registers and patients were followed in the registers from their first contact with psychiatric in- and outpatient care until October 2011.
Patients had impaired attention, processing speed and executive function as measured by Trail Making Test part B; their executive functions, as measured by the Wisconsin Card Sorting Test (WCST), and working memory, as measured by Rigshospitalet's digit span test, were unaffected as compared to norms. The admission rate, from schizophrenia diagnosis to the end of the study, was predicted by Trail Making Test part A, Rey's Auditory Verbal Learning Test (RAVLT), RAVLT (total learning), RAVLT (memory), d2 Test of Attention (total) and d2 type 2 error (error of commission), independent of gender, age and schizophrenia subtype. The length of hospitalization after the schizophrenia diagnosis was mainly determined by the schizophrenia subtype (schizophrenia simplex: incidence rate ratio (IRR) 0.24; 95% confidence interval (CI) 0.15-0.40, p < 0.001). Diagnosis was secondarily determined by deficits in attention and executive function, Trail Making Test part B, d2 Test of Attention (total), d2 type 1 error (error of omission), d2 type 2 error, and also by age and substance use disorder. The outpatient contact rate from schizophrenia diagnosis to the end of the study was predicted by d2 Test of Attention, Trail Making Test part A, and d2 type 2 error. The annual rate of criminal conviction, institutionalization and social retirement pension was mainly predicted by substance misuse.
Cognitive function only predicted hospitalization and outpatient contacts to a minor degree in a cohort of newly diagnosed patients with schizophrenia.
研究认知功能与临床结局变量之间的相关性。
2004 年 1 月至 2010 年 6 月期间首次被诊断为精神分裂症的患者在诊断程序的同时接受认知测试。将认知测试数据与丹麦医疗保健登记处相连接，并在登记处中从患者首次接触精神科门诊和住院治疗开始对其进行随访，直至 2011 年 10 月。
与正常值相比，患者的注意力、加工速度和执行功能（测试为 Trail Making Test 部分 B）受损，而他们的执行功能（测试为 Wisconsin Card Sorting Test [WCST]）和工作记忆（测试为 Rigshospitalet 的数字跨度测试）则未受影响。Trail Making Test 部分 A、Rey 的听觉言语学习测试（RAVLT）、RAVLT（总学习）、RAVLT（记忆）、d2 注意力测试（总）和 d2 类型 2 错误（错误）等认知测试的测试结果可以预测从精神分裂症诊断到研究结束时的入院率，而这些测试结果与性别、年龄和精神分裂症亚型无关。精神分裂症诊断后的住院时间主要取决于精神分裂症亚型（精神分裂症单纯型：发病率比（IRR）0.24；95%置信区间（CI）0.15-0.40，p<0.001）。其次，诊断还与注意力和执行功能、Trail Making Test 部分 B、d2 注意力测试（总）、d2 类型 1 错误（遗漏错误）、d2 类型 2 错误、年龄和物质使用障碍有关。从精神分裂症诊断到研究结束时的门诊接触率则由 d2 注意力测试、Trail Making Test 部分 A 和 d2 类型 2 错误预测。每年的犯罪定罪率、住院率和社会退休金的主要预测因素是物质滥用。
在一组新诊断的精神分裂症患者中，认知功能仅在一定程度上预测住院和门诊接触情况。
