Gould Felicia, Dunlop Boadie W, Rosenthal Jennifer B, Iosifescu Dan V, Mathew Sanjay J, Neylan Thomas C, Rothbaum Barbara O, Nemeroff Charles B, Harvey Philip D
Department of Psychiatry & Behavioral Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA.
Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Arch Clin Neuropsychol. 2019 Jun 1;34(4):539-547. doi: 10.1093/arclin/acy064.
In addition to clinical symptoms, patients with posttraumatic stress disorder (PTSD) often experience considerable disability and may evidence minor impairments in performance on measures of cognition and functional capacity (FC). The objective of the present study was to determine if cognitive and functional skills manifest temporal stability as observed in other neuropsychiatric conditions in the presence of greater fluctuations in clinical symptoms.
Assessments of cognition, FC, and clinical symptoms were conducted over two time points as part of a pre- and post-treatment assessment in a placebo-controlled clinical trial in 96 women with PTSD. The goal of these analyses was to examine the relative stability of scores and intercorrelations of measures of cognition, FC, and clinical symptoms.
Cognitive and FC performance manifested considerably greater cross-temporal stability compared to clinical symptoms. FC performance did not change over time. Similar to previous findings in patients with schizophrenia and bipolar disorder measures of symptoms and self-reported disability did not correlate with measures of functional skills or cognitive performance.
Cognitive performance and functional capacity were temporally stable in women with PTSD. In contrast, clinical symptoms had much more cross-temporal fluctuation. Self-reported disability was correlated with current symptomatology but unrelated to objective measures of performance. Similar to other neuropsychiatric conditions, mood symptoms likely influence estimates of current level of functioning more than cognitive or functional skills.
除了临床症状外,创伤后应激障碍(PTSD)患者常伴有明显的功能障碍,并且在认知和功能能力(FC)测量中可能表现出轻微损害。本研究的目的是确定在临床症状波动较大的情况下,认知和功能技能是否如在其他神经精神疾病中观察到的那样表现出时间稳定性。
在一项安慰剂对照临床试验中,对96名PTSD女性患者进行治疗前和治疗后的评估,在两个时间点进行认知、FC和临床症状评估。这些分析的目的是检验认知、FC和临床症状测量得分的相对稳定性以及相互间的相关性。
与临床症状相比,认知和FC表现出明显更高的跨时间稳定性。FC表现并未随时间变化。与先前对精神分裂症和双相情感障碍患者的研究结果相似,症状测量和自我报告的功能障碍与功能技能或认知表现测量无关。
PTSD女性患者的认知表现和功能能力在时间上是稳定的。相比之下,临床症状有更多的跨时间波动。自我报告的功能障碍与当前症状相关,但与客观表现测量无关。与其他神经精神疾病相似,情绪症状可能比认知或功能技能更能影响当前功能水平的评估。