Mam-Lam-Fook C, Danset-Alexandre C, Pedron L, Amado I, Gaillard R, Krebs M-O
Service hospitalo-universitaire, CJAAD, centre hospitalier Sainte-Anne, 75014 Paris, France; Faculté de médecine, université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Inserm, laboratoire de « physiopathologie des maladies psychiatriques », centre de psychiatrie et neurosciences, U894, institut de psychiatrie (GDR3557), 75014 Paris, France; Inserm, laboratoire « mémoire et cognition », centre de psychiatrie et neurosciences, CPN U894, institut de psychiatrie (GDR 3557), 75014 Paris, France.
Service hospitalo-universitaire, CJAAD, centre hospitalier Sainte-Anne, 75014 Paris, France; Faculté de médecine, université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Inserm, laboratoire de « physiopathologie des maladies psychiatriques », centre de psychiatrie et neurosciences, U894, institut de psychiatrie (GDR3557), 75014 Paris, France; Service hospitalo-universitaire, C3RP, centre hospitalier Sainte-Anne, 75014 Paris, France.
Encephale. 2017 May;43(3):241-253. doi: 10.1016/j.encep.2017.02.001. Epub 2017 Mar 25.
Cognitive disorders are currently considered as central components of disorders found in schizophrenia and are a major handicap for patients day to day. These disorders appear before the first psychotic episode, in the prodromal phase, during which time the symptoms are below the threshold for psychosis. People with these symptoms are considered as presenting an at-risk mental state (or at ultra-high risk, UHR of psychosis) and their risk for psychotic transition is between 20% and 40% within one year. Despite a number of studies, the chronology in which cognitive disorders appear in relation to the psychotic symptoms has not clearly been established and the study of the links between cognition and symptoms could improve our understanding of psychotic disorders. The detection of certain cognitive disorders before the onset of psychotic disorders could help improve early detection. We carried out a systematic analysis of the literature exploring cognitive disorders found in subjects with UHR for psychosis. The objective of most studies was to establish the predictive value for psychotic transition. Nevertheless study results have shown little consensus. Faced with this heterogeneity of results from past studies, we carried out a critical analysis of the literature and suggest areas of reflection for future research.
目前，认知障碍被视为精神分裂症相关疾病的核心组成部分，并且是患者日常生活中的主要障碍。这些障碍在首次精神病发作之前，即前驱期就已出现，在此期间症状低于精神病阈值。有这些症状的人被认为处于精神病风险状态（或超高风险，UHR），他们在一年内发生精神病转变的风险在20%至40%之间。尽管有许多研究，但认知障碍相对于精神病症状出现的时间顺序尚未明确确定，对认知与症状之间联系的研究可能会增进我们对精神病性障碍的理解。在精神病性障碍发作之前检测到某些认知障碍有助于改善早期发现。我们对探索精神病超高风险受试者中认知障碍的文献进行了系统分析。大多数研究的目的是确定精神病转变的预测价值。然而，研究结果几乎没有达成共识。面对过去研究结果的这种异质性，我们对文献进行了批判性分析，并提出了未来研究的思考方向。
