Anda Liss, Brønnick Kolbjørn S, Johnsen Erik, Kroken Rune A, Jørgensen Hugo, Løberg Else-Marie
TIPS, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway.
Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
PLoS One. 2016 Dec 15;11(12):e0167390. doi: 10.1371/journal.pone.0167390. eCollection 2016.
Cognitive impairment is a core aspect of psychosis, but the course of cognitive functioning during acute psychosis remains poorly understood, as does the association between symptom change and neurocognitive change. Some studies have found cognitive improvement to be related to improvement in negative symptoms, but few have examined cognitive changes in the early acute phase, when clinical improvement mainly happens. This study's aim was to investigate the relation between cognitive and symptomatic change in clinically heterogeneous patients during the early acute phase of psychosis.
Participants (n = 84), including both first-episode and previously ill patients, were recruited from consecutive admissions to the acute psychiatric emergency ward of Haukeland University Hospital, Bergen, Norway, as part of the Bergen Psychosis Project (BPP). The RBANS neurocognitive test battery was administered on admission and again at discharge from the acute ward (mean time 4.1 weeks, SD 1.86 weeks). Symptomatic change was measured by PANSS.
The proportion of subjects with cognitive impairment (t < 35) was 28.6% in the acute phase and 13.1% at follow-up. A sequential multiple linear regression model with RBANS change as the dependent variable found PANSS negative symptoms change to significantly predict total RBANS performance improvement (beta = -.307, p = .016). There was no significant difference between subjects with schizophrenia and those with other psychotic disorders in terms of cognitive change.
The proportion of subjects with mild to moderate impairment in cognitive test performance is reduced across the acute phase of psychosis, with improvement related to amelioration of negative symptoms.
认知障碍是精神病的一个核心方面，但急性精神病期间认知功能的进程仍知之甚少，症状变化与神经认知变化之间的关联也是如此。一些研究发现认知改善与阴性症状的改善有关，但很少有研究考察临床改善主要发生的早期急性期的认知变化。本研究的目的是调查精神病早期急性期临床异质性患者认知与症状变化之间的关系。
作为卑尔根精神病项目（BPP）的一部分，从挪威卑尔根豪克兰大学医院急性精神病急诊病房连续收治的患者中招募了84名参与者，包括首发患者和既往患病患者。在入院时和急性病房出院时（平均时间4.1周，标准差1.86周）进行RBANS神经认知测试组。症状变化通过阳性和阴性症状量表（PANSS）进行测量。
急性期认知障碍（t<35）患者的比例为28.6%，随访时为13.1%。以RBANS变化为因变量的序贯多元线性回归模型发现，PANSS阴性症状变化可显著预测RBANS总体表现的改善（β=-0.307，p=0.016）。在认知变化方面，精神分裂症患者和其他精神障碍患者之间没有显著差异。
在精神病的急性期，认知测试表现为轻度至中度受损的受试者比例降低，改善与阴性症状的改善有关。
