Chen Ce, Jiang Wenhui, Zhong Na, Wu Jin, Jiang Haifeng, Du Jiang, Li Ye, Ma Xiancang, Zhao Min, Hashimoto Kenji, Gao Chengge
Department of Psychiatry, First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Schizophr Res. 2014 Nov;159(2-3):478-84. doi: 10.1016/j.schres.2014.09.005. Epub 2014 Sep 30.
Although first-episode drug naive patients with schizophrenia are known to show cognitive impairment, the cognitive performances of these patients, who suffer deficit syndrome, compared with those who suffer non-deficit syndrome is undetermined. The aim of this study was to compare cognitive performances in first-episode drug-naive schizophrenia with deficit syndrome or non-deficit syndrome. First-episode drug naive patients (n=49) and medicated patients (n=108) with schizophrenia, and age, sex, and education matched healthy controls (n=57 for the first-episode group, and n=128 for the medicated group) were enrolled. Patients were divided into deficit or non-deficit syndrome groups, using the Schedule for Deficit Syndrome. Cognitive performance was assessed using the CogState computerized cognitive battery. All cognitive domains in first-episode drug naive and medicated patients showed significant impairment compared with their respective control groups. Furthermore, cognitive performance in first-episode drug naive patients was significantly worse than in medicated patients. Interestingly, the cognitive performance markers of processing speed and attention, in first-episode drug naive patients with deficit syndrome, were both significantly worse than in equivalent patients without deficit syndrome. In contrast, no differences in cognitive performance were found between the two groups of medicated patients. In conclusion, this study found that first-episode drug naive schizophrenia with deficit syndrome showed significantly impaired processing speed and attention, compared with patients with non-deficit syndrome. These findings highlight processing speed and attention as potential targets for pharmacological and psychosocial interventions in first-episode schizophrenia with deficit syndrome, since these domains are associated with social outcomes.
尽管已知首发未用药的精神分裂症患者存在认知障碍,但与非缺陷综合征患者相比,这些患有缺陷综合征的患者的认知表现尚不确定。本研究的目的是比较首发未用药的伴有缺陷综合征或非缺陷综合征的精神分裂症患者的认知表现。纳入了首发未用药的精神分裂症患者(n = 49)和用药的精神分裂症患者(n = 108),以及年龄、性别和教育程度相匹配的健康对照者(首发组n = 57,用药组n = 128)。使用缺陷综合征量表将患者分为缺陷或非缺陷综合征组。使用CogState计算机化认知测试组合评估认知表现。与各自的对照组相比,首发未用药和用药的患者的所有认知领域均表现出显著损害。此外,首发未用药患者的认知表现明显比用药患者差。有趣的是,伴有缺陷综合征的首发未用药患者在处理速度和注意力方面的认知表现指标均明显比无缺陷综合征的同类患者差。相比之下,两组用药患者的认知表现没有差异。总之,本研究发现,与非缺陷综合征患者相比,伴有缺陷综合征的首发未用药精神分裂症患者的处理速度和注意力明显受损。这些发现突出了处理速度和注意力作为伴有缺陷综合征的首发精神分裂症药物和心理社会干预潜在靶点的地位,因为这些领域与社会结局相关。