神经心理学功能预测情感性和非情感性精神病的社区结局：6 个月随访。
Neuropsychological functioning predicts community outcomes in affective and non-affective psychoses: a 6-month follow-up.
机构信息
Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St., Belmont, MA 02478 USA.
出版信息
Schizophr Res. 2013 Aug;148(1-3):34-7. doi: 10.1016/j.schres.2013.05.012. Epub 2013 Jun 19.
INTRODUCTION
Neurocognitive dysfunction is a major symptom feature of schizophrenia and bipolar disorder. A prognostic relationship between cognition and community outcomes is well-documented in schizophrenia and increasingly recognized in bipolar disorder. However, specific associations among neurocognition, diagnosis, state symptomatology, and community functioning are unclear, and few studies have compared these relationships among patients with affective and non-affective psychoses in the same study. We examined neurocognitive, clinical, and community functioning in a cross-diagnostic sample of patients with psychotic disorders over a 6-month follow-up interval.
METHOD
Neurocognitive, clinical and community functioning were assessed in participants with schizophrenia (n=13), schizoaffective disorder (n=17), or bipolar disorder with psychosis (n=18), and healthy controls (n=18) at baseline and 6months later.
RESULTS
Neurocognitive functioning was impaired in all diagnostic groups and, despite reductions in primary symptoms, did not recover on most measures over the follow-up period. Neurocognitive impairment was not associated with diagnosis or clinical improvement. Several neurocognitive scores at baseline (but not diagnosis or clinical baseline or follow-up scores) predicted community functioning at follow-up.
DISCUSSION
In one of the few studies to longitudinally examine neurocognition in association with clinical and outcomes variables in a cross diagnostic sample of psychotic disorders patients, neurocognitive deficits were pronounced across diagnoses and did not recover on most measures despite significant reductions in clinical symptoms. Baseline neurocognitive functioning was the only significant predictor of patients' community functioning six months later. Efforts to recognize and address cognitive deficits, an approach that has shown promise in schizophrenia, should be extended to all patients with psychosis.
简介
神经认知功能障碍是精神分裂症和双相情感障碍的主要症状特征。认知功能与社区结局之间的预后关系在精神分裂症中已有充分记录，在双相情感障碍中也越来越受到认可。然而，神经认知功能、诊断、状态症状和社区功能之间的具体关联尚不清楚，并且很少有研究在同一研究中比较情感性和非情感性精神病患者之间的这些关系。我们在 6 个月的随访期间检查了患有精神病性障碍的患者的神经认知、临床和社区功能。
方法
在基线和 6 个月后，对精神分裂症（n=13）、分裂情感障碍（n=17）或伴有精神病的双相情感障碍（n=18）患者和健康对照组（n=18）进行神经认知、临床和社区功能评估。
结果
所有诊断组的神经认知功能均受损，尽管主要症状有所减轻，但在随访期间大多数测量指标均未恢复。神经认知障碍与诊断或临床改善无关。基线时的一些神经认知评分（但不是诊断或临床基线或随访评分）预测了随访时的社区功能。
讨论
在为数不多的几项研究之一中，我们对跨诊断的精神病患者样本进行了纵向检查，以研究神经认知与临床和结局变量之间的关系，结果表明，神经认知缺陷在所有诊断中均很明显，并且尽管临床症状明显减轻，但在大多数测量指标上均未恢复。基线时的神经认知功能是预测患者六个月后社区功能的唯一重要指标。应该将识别和解决认知缺陷的方法（该方法在精神分裂症中显示出了希望）扩展到所有精神病患者。
Zotero 插件