Servicio de Salud del Principado de Asturias, Oviedo, Spain; Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Department of Psychiatry, University of Oviedo, Spain.
Servicio de Salud del Principado de Asturias, Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain.
Psychiatry Res. 2019 Oct;280:112509. doi: 10.1016/j.psychres.2019.112509. Epub 2019 Aug 16.
Several studies indicate that negative and cognitive symptoms are determining factors of functioning in patients with schizophrenia. However, they do not usually include biological aspects, such as inflammatory markers. The current prospective study aims to identify clinical and biological factors predicting real-world functioning, at baseline and at one-year follow-up, of outpatients in an early stage of schizophrenia. Sample consist of 73 clinically stable patients with schizophrenia, of which 57 completed the one-year follow-up. Accurate psychopathology, functioning, and cognitive assessments were performed at baseline and follow-up (Positive and Negative Syndrome, Brief Negative Symptom, Calgary Depression, Personal and Social Performance Scales, and MATRICS Cognitive Consensus Battery). Biological biomarkers including anthropometric data and blood parameters were collected. Pearson correlation and multiple regression analyses including potential confounding factors were performed. Negative symptoms (especially asociality and avolition), along with the inflammatory biomarker interleukin-2, are the most important determining factors of poor real-world functioning in early-stage schizophrenia. The previous functioning, along with baseline cognitive performance in attention and vigilance, predicts functioning at one-year follow-up in these patients. Strategies aimed at improving negative and cognitive symptoms, as well as modifying certain inflammatory pathways, should be the targets to achieve functional recovery in the first years of schizophrenia.
多项研究表明，阴性症状和认知症状是精神分裂症患者功能的决定因素。然而，它们通常不包括生物方面，如炎症标志物。本前瞻性研究旨在确定基线和一年随访时预测精神分裂症早期门诊患者现实世界功能的临床和生物学因素。样本包括 73 名临床稳定的精神分裂症患者，其中 57 名完成了一年随访。在基线和随访时进行了准确的精神病学、功能和认知评估（阳性和阴性综合征量表、简短阴性症状量表、卡尔加里抑郁量表、个人和社会表现量表以及 MATRICS 认知共识电池）。收集了包括人体测量数据和血液参数在内的生物标志物。进行了 Pearson 相关和多元回归分析，包括潜在的混杂因素。阴性症状（特别是社交障碍和意志缺失）和炎症生物标志物白细胞介素-2 是早期精神分裂症患者现实世界功能不良的最重要决定因素。之前的功能以及注意力和警觉性的基线认知表现可预测这些患者一年随访时的功能。旨在改善阴性和认知症状以及改变某些炎症途径的策略应是实现精神分裂症早期功能恢复的目标。
