Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Psychiatry Clin Neurosci. 2017 May;71(5):318-327. doi: 10.1111/pcn.12522.
There is an increasing need for identifying neurocognitive predictors of global functional outcome in early psychosis toward optimizing an early intervention strategy.
We conducted a longitudinal observational study to investigate an association between neurocognitive assessments at baseline and global functional outcome at an average of 1-year follow up. Participants included ultra-high-risk for psychosis (UHR) individuals who had not converted to psychosis during the follow-up period (UHR-NP) and those with first-episode psychosis (FEP). We evaluated neurocognition at baseline using the Brief Assessment of Cognition in Schizophrenia Japanese version, including Verbal Memory, Working Memory, Motor Speed, Verbal Fluency, Attention/Processing Speed, and Executive Function. We also assessed global functional outcome using the modified Global Assessment of Functioning (mGAF) scale both at baseline and after the follow-up period.
Thirty-four UHR-NP individuals (34/47, 72%) and 29 FEP individuals (29/36, 81%) completed assessment of neurocognitive function at baseline and functional outcome at follow up. In the UHR-NP group, Attention/Processing Speed was significantly associated with the mGAF score at follow up. In the FEP group, Executive Function was significantly associated with the average mGAF score during follow up.
Attention/Processing Speed and Executive Function at baseline may predict global functional outcome of early psychosis. These neurocognitive tests are easy to incorporate in clinical settings and, if replicated in independent samples, may be included in routine clinical assessments for prediction of functional outcome in early psychosis.
在早期精神病中，需要越来越多地识别神经认知预测因子，以优化早期干预策略，从而实现整体功能结局。
我们进行了一项纵向观察性研究，旨在调查基线时的神经认知评估与平均 1 年随访时的整体功能结局之间的关联。参与者包括未在随访期间转变为精神病的精神病超高风险（UHR）个体（UHR-NP）和首发精神病（FEP）个体。我们使用日本版Brief Assessment of Cognition in Schizophrenia 评估基线时的神经认知，包括言语记忆、工作记忆、运动速度、言语流畅性、注意力/处理速度和执行功能。我们还在基线和随访后使用改良的全球功能评估（mGAF）量表评估整体功能结局。
34 名 UHR-NP 个体（34/47，72%）和 29 名 FEP 个体（29/36，81%）完成了基线时的神经认知功能评估和随访时的功能结局评估。在 UHR-NP 组中，注意力/处理速度与随访时的 mGAF 评分显著相关。在 FEP 组中，执行功能与随访期间的平均 mGAF 评分显著相关。
基线时的注意力/处理速度和执行功能可能预测早期精神病的整体功能结局。这些神经认知测试易于在临床环境中实施，如果在独立样本中得到验证，可能会被纳入早期精神病的常规临床评估中，以预测功能结局。
