Department of Psychology, York University.
Department of Psychology, McMaster University.
Neuropsychology. 2014 May;28(3):353-8. doi: 10.1037/neu0000026. Epub 2014 Mar 17.
The main purpose of this investigation was to identify patterns of intellectual performance in schizophrenia patients suggesting preserved, deteriorated, and premorbidly impaired ability, and to determine clinical, cognitive, and functional correlates of these patterns.
We assessed 101 patients with schizophrenia or schizoaffective disorder and 80 non-psychiatric control participants. The "preserved" performance pattern was defined by average-range estimated premorbid and current IQ with no evidence of decline (premorbid-current IQ difference <10 points). The "deteriorated" pattern was defined by a difference between estimated premorbid and current IQ estimates of 10 points or more. The premorbidly "impaired" pattern was defined by below average estimated premorbid and current IQ and no evidence of decline greater than 10 points. Preserved and deteriorated patterns in healthy controls were also identified and studied in comparison to patient findings. The groups were compared on demographic, neurocognitive, clinical and functionality variables.
Patients with the preserved pattern outperformed those meeting criteria for deteriorated and compromised intellectual ability on a composite measure of neurocognitive ability as well as in terms of functional competence. Patients demonstrating the deteriorated and compromised patterns were equivalent across all measures. However, "preserved" patients failed to show any advantage in terms of community functioning and demonstrated cognitive impairments relative to control participants.
Our results suggest that proposed patterns of intellectual decline and stability exist in both the schizophrenia and general populations, but may not hold true across other cognitive abilities and do not translate into differential functional outcome.
本研究的主要目的是识别精神分裂症患者智力表现模式，提示存在保持、恶化和发病前受损的能力，并确定这些模式的临床、认知和功能相关性。
我们评估了 101 名精神分裂症或分裂情感障碍患者和 80 名非精神科对照参与者。“保持”表现模式的定义是平均范围的估计发病前和当前 IQ，没有下降的证据（发病前-当前 IQ 差异<10 分）。“恶化”模式的定义是估计发病前和当前 IQ 之间的差异为 10 分或以上。“发病前受损”模式的定义是平均以下的估计发病前和当前 IQ，且没有超过 10 分的下降证据。在健康对照组中也确定并研究了保持和恶化模式，并与患者发现进行比较。对人口统计学、神经认知、临床和功能变量进行了比较。
在神经认知能力综合测量以及功能能力方面，表现出保持模式的患者优于符合恶化和智力受损标准的患者。表现出恶化和受损模式的患者在所有测量中都相当。然而，“保持”患者在社区功能方面没有表现出任何优势，并且相对于对照组参与者表现出认知障碍。
我们的结果表明，智力下降和稳定的预期模式在精神分裂症和一般人群中都存在，但可能不适用于其他认知能力，也不会转化为不同的功能结果。
