Cuesta Manuel J, Sánchez-Torres Ana M, Cabrera Bibiana, Bioque Miquel, Merchán-Naranjo Jessica, Corripio Iluminada, González-Pinto Ana, Lobo Antonio, Bombín Igor, de la Serna Elena, Sanjuan Julio, Parellada Mara, Saiz-Ruiz Jerónimo, Bernardo Miquel
Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
Schizophr Res. 2015 May;164(1-3):65-73. doi: 10.1016/j.schres.2015.02.022. Epub 2015 Mar 26.
The extent to which socio-demographic, clinical, and premorbid adjustment variables contribute to cognitive deficits in first-episode schizophrenia spectrum disorders remains to be ascertained.
To examine the pattern and magnitude of cognitive impairment in first-episode psychosis patients, the profile of impairment across psychosis subtypes and the associations with premorbid adjustment.
226 first-episode psychosis patients and 225 healthy controls were assessed in the PEPsCog study, as part of the PEPs study.
Patients showed slight to moderate cognitive impairment, verbal memory being the domain most impaired compared to controls. Broad affective spectrum patients had better premorbid IQ and outperformed the schizophrenia and other psychosis groups in executive function, and had better global cognitive function than the schizophrenia group. Adolescent premorbid adjustment together with age, gender, parental socio-economic status, and mean daily antipsychotic doses were the factors that best explained patients' cognitive performance. General and adolescent premorbid adjustment, age and parental socio-economic status were the best predictors of cognitive performance in controls.
Poorer premorbid adjustment together with socio-demographic factors and higher daily antipsychotic doses were related to a generalized cognitive impairment and to a lower premorbid intellectual reserve, suggesting that neurodevelopmental impairment was present before illness onset.
社会人口统计学、临床和病前适应变量对首发精神分裂症谱系障碍认知缺陷的影响程度尚待确定。
研究首发精神病患者认知损害的模式和程度、不同精神病亚型的损害特征以及与病前适应的关联。
作为PEPs研究的一部分，在PEPsCog研究中对226例首发精神病患者和225名健康对照者进行了评估。
患者表现出轻度至中度认知损害，与对照组相比，言语记忆是受损最严重的领域。广泛情感谱系患者病前智商较高，在执行功能方面优于精神分裂症和其他精神病组，且整体认知功能比精神分裂症组更好。青少年病前适应以及年龄、性别、父母社会经济地位和每日抗精神病药物平均剂量是最能解释患者认知表现的因素。一般和青少年病前适应、年龄和父母社会经济地位是对照组认知表现的最佳预测因素。
较差的病前适应以及社会人口统计学因素和较高的每日抗精神病药物剂量与广泛性认知损害和较低的病前智力储备有关，提示在疾病发作前存在神经发育损害。
