Kenney Joanne, Anderson-Schmidt Heike, Scanlon Cathy, Arndt Sophia, Scherz Elisabeth, McInerney Shane, McFarland John, Byrne Fintan, Ahmed Mohamed, Donohoe Gary, Hallahan Brian, McDonald Colm, Cannon Dara M
Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland.
Department of Psychiatry and Psychotherapy, University Medical Centre Goettingen, Georg-August University, Goettingen, Germany.
Schizophr Res. 2015 Dec;169(1-3):101-108. doi: 10.1016/j.schres.2015.09.007. Epub 2015 Sep 26.
While cognitive impairments are prevalent in first-episode psychosis, the course of these deficits is not fully understood. Most deficits appear to remain stable, however there is uncertainty regarding the trajectory of specific cognitive domains after illness onset. This study investigates the longitudinal course of cognitive deficits four years after a first-episode of psychosis and the relationship of performance with clinical course and response to treatment. Twenty three individuals with psychotic illness, matched with 21 healthy volunteers, were assessed using the MATRICS Consensus Cognitive Battery at illness onset and 4 years later. We also investigated the relationship between cognitive deficits and quality of life and clinical indices. Verbal learning and two measures of processing speed had marked poorer trajectory over four years compared to the remaining cognitive domains. Processing speed performance was found to contribute to the cognitive deficits in psychosis. Poorer clinical outcome was associated with greater deficits at illness onset in reasoning and problem solving and social cognition. Cognitive deficits did not predict quality of life at follow-up, nor did diagnosis subtype differentiate cognitive performance. In conclusion, an initial psychotic episode may be associated with an additional cost on verbal learning and two measures of processing speed over a time spanning at least four years. Moreover, processing speed, which has been manipulated through intervention in previous studies, may represent a viable therapeutic target. Finally, cognition at illness onset may have a predictive capability of illness course.
虽然认知障碍在首发精神病中很普遍，但这些缺陷的病程尚未完全明了。大多数缺陷似乎保持稳定，然而，疾病发作后特定认知领域的发展轨迹仍存在不确定性。本研究调查了首发精神病四年后的认知缺陷纵向病程，以及认知表现与临床病程和治疗反应之间的关系。23名精神病患者与21名健康志愿者相匹配，在疾病发作时和4年后使用MATRICS共识认知成套测验进行评估。我们还研究了认知缺陷与生活质量和临床指标之间的关系。与其余认知领域相比，言语学习和两种处理速度测量在四年中的发展轨迹明显较差。发现处理速度表现导致了精神病中的认知缺陷。较差的临床结果与疾病发作时推理、解决问题和社会认知方面的更大缺陷相关。认知缺陷在随访时不能预测生活质量，诊断亚型也不能区分认知表现。总之，首次精神病发作可能与至少四年时间跨度内言语学习和两种处理速度测量方面的额外代价有关。此外，在先前研究中通过干预进行调节的处理速度可能是一个可行的治疗靶点。最后，疾病发作时的认知可能对病程具有预测能力。
