Department of Community medicine, Believers Church Medical College, Thiruvalla, Kerala, India.
Department of Biostatistics and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
Asian J Psychiatr. 2018 Dec;38:96-101. doi: 10.1016/j.ajp.2017.11.006. Epub 2017 Nov 7.
Impairment in cognitive variables and alterations in circadian function have been documented among patients with schizophrenia (SZ) and bipolar I disorder (BP1), but it is not known whether joint analysis of these variables can define clinically relevant sub-groups in either disorder.
To evaluate the pattern and relationship of cognitive and circadian function in SZ and BP1 patients with respect to diagnosis and indices of clinical severity.
Among patients with SZ and BP1, cognitive function was evaluated using the Penn Computerized Neurocognitive Battery and circadian function was assessed using the Composite Scale of Morningness/ Eveningness (CSM). Clinical severity was estimated using the Global Assessment of Function (GAF) scale, and age at onset of illness (AAO). The patients were compared with community based non-psychotic control individuals and non-psychotic first degree relatives of the SZ patients. The cluster distributions of cognitive function, circadian function and clinical severity were investigated and identified clusters compared across diagnostic groups.
Across participants, the cognitive domains could be separated into two clusters. Cluster 1 included the majority of control individuals and non-psychotic relatives, while SZ patients predominated in Cluster 2. BP1 patients were distributed across both clusters. The clusters could be differentiated by GAF scores, but not AAO. CSM scores were not significantly correlated with individual cognitive domains or with the clusters.
Clusters based on levels of cognitive function can discriminate SZ patients from control individuals, but not BP1 patients. CSM scores do not contribute to such discrimination.
认知变量的损伤和昼夜节律功能的改变已在精神分裂症（SZ）和双相情感障碍 I 型（BP1）患者中得到证实，但尚不清楚这些变量的联合分析是否可以在任何一种疾病中定义具有临床意义的亚组。
评估 SZ 和 BP1 患者认知和昼夜节律功能的模式和关系，以及它们与诊断和临床严重程度指标的关系。
在 SZ 和 BP1 患者中，使用宾夕法尼亚计算机神经认知电池评估认知功能，使用综合晨/晚量表（CSM）评估昼夜节律功能。使用总体功能评估（GAF）量表和发病年龄（AAO）来评估临床严重程度。将患者与社区非精神病对照个体和 SZ 患者的非精神病一级亲属进行比较。研究了认知功能、昼夜节律功能和临床严重程度的聚类分布，并比较了不同诊断组的聚类。
在所有参与者中，认知域可以分为两个聚类。聚类 1 包括大多数对照个体和非精神病亲属，而 SZ 患者则主要集中在聚类 2。BP1 患者分布在两个聚类中。聚类可以通过 GAF 评分来区分，但不能通过 AAO 来区分。CSM 评分与个体认知域或聚类均无显著相关性。
基于认知功能水平的聚类可以区分 SZ 患者和对照个体，但不能区分 BP1 患者。CSM 评分不能有助于这种区分。
