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首发非情感性精神病患者的诊断与神经认知概况

Diagnosis and neurocognitive profiles in first-episode non-affective psychosis patients.

作者信息

Ayesa-Arriola Rosa, Rodríguez-Sánchez José Manuel, Suero Esther Setién, Reeves Lauren E, Tabarés-Seisdedos Rafael, Crespo-Facorro Benedicto

机构信息

Department of Psychiatry, IDIVAL, School of Medicine, Marqués de Valdecilla University Hospital, University of Cantabria, Avda. Valdecilla s/n, 39008, Santander, Spain.

CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2016 Oct;266(7):619-28. doi: 10.1007/s00406-015-0667-0. Epub 2016 Jan 14.

Abstract

This study explored whether there are distinguishable neurocognitive profiles in diagnostic subgroups of first-episode non-affective psychosis (FEP) patients. Four hundred and eighty-seven individuals with diagnoses of non-affective psychosis disorders were evaluated 6 months after first contact with psychiatric services. Individuals with schizophrenia (n = 257), schizophreniform (n = 141), brief psychotic disorder (n = 54), and psychosis not otherwise specified (n = 35) were compared on baseline neuropsychological variables using analyses of variance and covariance with potential clinical, premorbid, and sociodemographic confounders. The brief psychotic disorder subgroup was the least impaired on global cognitive function, in particular when compared to the schizophrenia subgroup, and specifically on executive function, processing speed, and motor dexterity domains. However, with the exception of the processing speed domain, profile differences could be explained by sex, age, psychotic and negative symptoms, years of education, and premorbid IQ. These results suggest processing speed as a diagnostic marker for brief psychotic disorder in FEP patients. Further, there are quantitative and qualitative differences across the schizophrenia spectrum disorders subgroups, indicating different profiles with varying degrees of deficit.

摘要

本研究探讨了首发非情感性精神病(FEP)患者的诊断亚组中是否存在可区分的神经认知特征。487名被诊断为非情感性精神病障碍的个体在首次接触精神科服务6个月后接受了评估。使用方差分析和协方差分析,对精神分裂症患者(n = 257)、精神分裂症样障碍患者(n = 141)、短暂精神病性障碍患者(n = 54)和未另行指定的精神病患者(n = 35)的基线神经心理学变量进行了比较,并考虑了潜在的临床、病前和社会人口学混杂因素。短暂精神病性障碍亚组在整体认知功能方面受损最少,特别是与精神分裂症亚组相比,在执行功能、处理速度和运动敏捷性领域尤其如此。然而,除了处理速度领域外,特征差异可以由性别、年龄、精神病性和阴性症状、受教育年限和病前智商来解释。这些结果表明处理速度可作为FEP患者短暂精神病性障碍的诊断标志物。此外,精神分裂症谱系障碍亚组之间存在数量和质量上的差异,表明存在不同程度缺陷的不同特征。

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