Institute of Psychological Medicine and Clinical Neurosciences, MRC Center for Neuropsychiatric Genetics and Genomics, Cardiff University, and the Academic Unit of Psychiatry, School of Social and Community Medicine, University of Bristol, UK.
Am J Psychiatry. 2013 May;170(5):550-7. doi: 10.1176/appi.ajp.2012.12060792.
Psychotic experiences in children are associated with an elevated risk of developing psychosis. The authors investigated whether the pattern of cognitive deficits present in psychosis also exists in children with psychotic experiences within the general population.
The authors examined the longitudinal relationships between key cognitive domains, selected a priori based on their association with schizophrenia, and onset of psychotic experiences in children from the Avon Longitudinal Study of Parents and Children and whether these associations were independent of one another.
Lower performance in the domains of processing speed at age 8 years (odds ratio=1.24, 95% CI=1.12-1.36) and attention at age 11 (odds ratio=1.14, 95% CI=1.04-1.25) and decline of processing speed between the ages of 8 and 11 (odds ratio=1.29, 95% CI=1.15-1.45) were associated with higher risk of psychotic experiences at age 12. When adjusting for the other cognitive domains, processing speed at age 8 (odds ratio=1.20, 95% CI=1.09-1.33) was the measure most strongly associated with psychotic experiences.
Defective processing speed is a particularly strong predictor of psychotic experiences in children. Furthermore, the pattern of associations between cognition and psychotic experiences in children within the general population is similar to the one between cognition and schizophrenia. These findings have potentially important implications for understanding the pathogenesis of psychotic disorders and the specific deficits that seem to place children at higher risk of psychopathology.
儿童出现精神病性体验与发展为精神病的风险增加有关。作者研究了在一般人群中，是否存在与精神病性体验相关的认知缺陷模式也存在于具有精神病性体验的儿童中。
作者研究了关键认知领域之间的纵向关系，这些领域是根据它们与精神分裂症的关联预先选择的，并在儿童中研究了这些领域与精神病性体验发病之间的关系，以及这些关联是否相互独立。
8 岁时的处理速度（优势比=1.24，95%置信区间=1.12-1.36）和 11 岁时的注意力（优势比=1.14，95%置信区间=1.04-1.25）以及 8 至 11 岁之间的处理速度下降（优势比=1.29，95%置信区间=1.15-1.45）与 12 岁时出现精神病性体验的风险较高相关。在调整其他认知领域后，8 岁时的处理速度（优势比=1.20，95%置信区间=1.09-1.33）与精神病性体验相关性最强。
处理速度缺陷是儿童精神病性体验的一个特别强的预测指标。此外，一般人群中儿童认知与精神病性体验之间的关联模式与认知与精神分裂症之间的关联模式相似。这些发现对于理解精神病性障碍的发病机制以及似乎使儿童处于更高精神病理风险的特定缺陷具有潜在的重要意义。
