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首发精神分裂症与健康对照者认知功能的改善:一项 6 年多评估随访研究。

Cognitive improvement in first-episode schizophrenia and healthy controls: A 6-year multi-assessment follow-up study.

机构信息

Department of Psychology, University of Oslo, PO Box 1094, Oslo 0373, Norway; Vestre Viken Hospital Trust, PO Box 800, Drammen 3004, Norway.

Department of Psychology, University of Oslo, PO Box 1094, Oslo 0373, Norway; Division of Mental Health, Norwegian Institute of Public Health, PO Box 4404, Oslo 0403, Norway.

出版信息

Psychiatry Res. 2018 Sep;267:319-326. doi: 10.1016/j.psychres.2018.06.016. Epub 2018 Jun 18.

Abstract

The development of individual cognitive domains over time is not yet fully examined in first-episode schizophrenia (FES). This study's objective was to explore the cognitive trajectories of FES-patients (n = 28) and compare them to a pairwise matched healthy control group (n = 28, total n = 56). This study has a multi-assessment design, and includes patient data from seven assessments over six years. Healthy controls were assessed at baseline, after two years and after six years. Cognition was assessed with the MATRICS Consensus Cognitive Battery. Data were analyzed with linear multilevel models. FES-patients scored significantly lower than the control group across all cognitive domains at baseline. Over six years, improvements were seen in attention, verbal learning, processing speed, reasoning/ problem solving, working memory and social cognition. The overall trend points toward a similar cognitive change in both groups. The patient group's improvement in reasoning/ problem solving was significantly larger that the control group, but improvement in working memory was smaller. Cognitive improvements were seen under and after the initial psychosis episode and throughout the recovery process with 45.5% of the patients fully recovered by 6-year follow-up. Cognitive improvements were seen in almost every cognitive domain that is consistently impaired in FES.

摘要

个体认知领域随时间的发展在首发精神分裂症(FES)中尚未得到充分研究。本研究旨在探索 FES 患者(n=28)的认知轨迹,并将其与配对的健康对照组(n=28,总 n=56)进行比较。本研究采用多评估设计,包括 7 次评估的 6 年期间的患者数据。健康对照组在基线、两年后和六年后进行评估。认知采用 MATRICS 共识认知电池进行评估。使用线性多层模型进行数据分析。FES 患者在基线时所有认知领域的得分均显著低于对照组。六年后,注意力、词语学习、处理速度、推理/问题解决、工作记忆和社会认知方面均有改善。整体趋势表明两组的认知变化相似。患者组在推理/问题解决方面的改善明显大于对照组,但在工作记忆方面的改善较小。在精神病发作初始阶段和整个康复过程中都观察到认知改善,45.5%的患者在 6 年随访时完全康复。在几乎每个认知领域都观察到认知改善,而这些领域在 FES 中一直存在受损。

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