稳定期精神分裂症门诊患者的认知表现与功能结局的相关性

Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia.

作者信息

Zaragoza Domingo Silvia, Bobes Julio, García-Portilla Maria-Paz, Morralla Claudia

机构信息

Department of Psychiatry, Medical Psychology Unit, School of Medicine, Autonomous University of Barcelona, Campus de Bellaterra, s/n, 08193 Bellaterra, Cerdanyola del Vallès.

Psychiatry Department, University of Oviedo, CIBERSAM, Julián Clavería, 6, 33006 Oviedo, Spain.

出版信息

Schizophr Res Cogn. 2015 Apr 14;2(3):146-158. doi: 10.1016/j.scog.2015.03.002. eCollection 2015 Sep.

DOI:10.1016/j.scog.2015.03.002

PMID:29379764

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5779297/

Abstract

BACKGROUND–OBJECTIVE: Prevalence data of cognitive impairment in Schizophrenia based on large population samples are scarce. Our goal is to relate cognition and functional outcomes, and estimate prevalence of cognitive impairment in a large sample of schizophrenia outpatients treated with second-generation antipsychotics.

METHOD

A cross-sectional outpatient evaluation conducted during follow-up visits. Selection criteria included six-months stable treatment. The brief battery, EPICOG-SCH, covered four cognitive domains related to functional outcomes: (WAIS-III-Letter-Number-Sequencing), (Category Fluency Test; CFT), (WMS-III-Logical-Memory), and (Digit-Symbol-Coding and CFT). Clinical severity and functional impairment were assessed with CGI-SCH and WHO DAS-S. Impairment prevalence was calculated at ≤ 1.5 SD.

RESULTS

Among patients recruited ( = 848) in 234 participating centers, 672 were under 6-month treatment. 61.5% ( = 413) reported cognitive impairment according to CGI-SCH . Estimated prevalences were 85.9% (95% CI 85.6-86.2%) CFT-Fruits; 68.3% (95% CI 67.8-68.8%) CFT-; 38.1% (95% CI 37.5-38.3%) Digit-Symbol-Coding; 24.8% (95% CI 24.1-25.5%) ; 20.9% (95% CI 20.2-21.6%) Letter-Number Sequencing; 11.7% (95% CI 11.0-12.4%) Verbal Memory-Items. Negative and Depressive symptoms, Deficit Syndrome, and functional disability were related to poor performance. Functional disability was predicted by CGI-SCH-Overall severity (OR = 1.34635, p < 0.0001), CGI-SCH-Negative Symptoms (OR = 0.75540, p < 0.0001), (Letter-Number-Sequencing) (OR = - 0.16442, p = 0.0004) and the time-course (OR = 0.05083, p = 0.0094), explaining 47% of the observed variability.

CONCLUSION

Most prevalent impairments were on and domains; however, showed the strongest relationship to functional disability. Monitoring cognitive function during follow up is critical to understand patient's everyday functional capacity.

摘要

背景-目的：基于大样本人群的精神分裂症认知障碍患病率数据稀缺。我们的目标是关联认知与功能结局，并估计在接受第二代抗精神病药物治疗的大量精神分裂症门诊患者样本中认知障碍的患病率。

方法

在随访期间进行横断面门诊评估。选择标准包括六个月稳定治疗。简短量表EPICOG-SCH涵盖与功能结局相关的四个认知领域：（韦氏成人智力量表第三版-字母数字排序）、（类别流畅性测验；CFT）、（韦氏记忆量表第三版-逻辑记忆）以及（数字符号编码和CFT）。使用CGI-SCH和世界卫生组织残疾评定量表（WHO DAS-S）评估临床严重程度和功能损害。在≤1.5标准差时计算损害患病率。

结果

在234个参与中心招募的患者（n = 848）中，672例接受了六个月治疗。根据CGI-SCH，61.5%（n = 413）报告有认知障碍。估计的患病率分别为：CFT-水果85.9%（95%可信区间85.6 - 86.2%）；CFT-动物68.3%（95%可信区间67.8 - 68.8%）；数字符号编码38.1%（95%可信区间37.5 - 38.3%）；逻辑记忆24.8%（95%可信区间24.1 - 25.5%）；字母数字排序20.9%（95%可信区间20.2 - 21.6%）；言语记忆-项目11.7%（95%可信区间11.0 - 12.4%）。阴性和抑郁症状、缺陷综合征以及功能残疾与表现不佳相关。功能残疾可由CGI-SCH-总体严重程度（比值比=1.34635，p < 0.0001）、CGI-SCH-阴性症状（比值比=0.75540，p < 0.0001）、（字母数字排序）（比值比=-0.16442，p = 0.0004）以及病程（比值比=0.05083，p = 0.0094）预测，解释了观察到的变异性的47%。