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首发精神病患者的认知功能按阴性症状水平分层:一项为期 1 年的随访研究。

Cognitive functioning in patients with first-episode psychosis stratified by level of negative symptoms: A 1-year follow-up study.

机构信息

NORMENT, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, 0407 Oslo, Norway.

NORMENT, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, 0407 Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.

出版信息

Psychiatry Res. 2019 Nov;281:112554. doi: 10.1016/j.psychres.2019.112554. Epub 2019 Sep 3.

Abstract

We investigate negative symptoms over a 1-year follow-up period with the objective to see how groups defined according to level of symptom severity are related to cognition. Eighty-seven participants with first-episode psychosis (FEP) and matched healthy controls were assessed at baseline and follow-up. FEP participants were sub-grouped based on negative symptom items from the Positive and Negative Syndrome Scale (PANSS-R) with either no, mild, transitory or sustained symptoms over one year. Following an overall MANOVA, groups were compared on cognitive domains and a cognitive composite using ANOVAs. Cognitive course was explored with a MANOVA. We found a group effect on cognition. Participants who sustained negative symptoms were significantly outperformed by participants with no negative symptoms on executive functions and processing speed, and by those with mild or transitory symptoms on verbal learning and memory. Participants with sustained negative symptoms performed significantly poorer on the cognitive composite than those with no or mild negative symptoms. The group with no negative symptoms did not differ significantly from healthy controls on any cognitive measure, and the groups did not differ in cognitive course. Early course of negative symptoms is associated with cognition and could guide clinicians when evaluating need for cognitive assessment.

摘要

我们在为期一年的随访中研究了阴性症状,目的是观察根据症状严重程度定义的组别与认知之间的关系。共有 87 名首发精神病(FEP)患者和匹配的健康对照组在基线和随访时接受了评估。FEP 患者根据阳性和阴性综合征量表(PANSS-R)的阴性症状项目进行了亚组划分,这些项目在一年内表现为无、轻度、短暂或持续症状。在进行总体 MANOVA 后,采用 ANOVA 比较了不同组别的认知领域和认知综合表现。采用 MANOVA 探索了认知过程。我们发现认知方面存在组别效应。在执行功能和加工速度方面,持续存在阴性症状的患者显著落后于无阴性症状的患者,在言语学习和记忆方面则显著落后于轻度或短暂性症状的患者。持续存在阴性症状的患者在认知综合表现上显著差于无或轻度阴性症状的患者。无阴性症状的患者在任何认知测量上均与健康对照组无显著差异,且在认知过程方面也无差异。阴性症状的早期病程与认知相关,这可为临床医生评估认知评估需求提供指导。

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