Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, UK.
Psychol Med. 2022 Jan;52(2):323-331. doi: 10.1017/S0033291720002020. Epub 2020 Jun 22.
The nature and degree of cognitive impairments in schizoaffective disorder is not well established. The aim of this meta-analysis was to characterise cognitive functioning in schizoaffective disorder and compare it with cognition in schizophrenia and bipolar disorder. Schizoaffective disorder was considered both as a single category and as its two diagnostic subtypes, bipolar and depressive disorder.
Following a thorough literature search (468 records identified), we included 31 studies with a total of 1685 participants with schizoaffective disorder, 3357 with schizophrenia and 1095 with bipolar disorder. Meta-analyses were conducted for seven cognitive variables comparing performance between participants with schizoaffective disorder and schizophrenia, and between schizoaffective disorder and bipolar disorder.
Participants with schizoaffective disorder performed worse than those with bipolar disorder (g = -0.30) and better than those with schizophrenia (g = 0.17). Meta-analyses of the subtypes of schizoaffective disorder showed cognitive impairments in participants with the depressive subtype are closer in severity to those seen in participants with schizophrenia (g = 0.08), whereas those with the bipolar subtype were more impaired than those with bipolar disorder (g = -0.23) and less impaired than those with schizophrenia (g = 0.29). Participants with the depressive subtype had worse performance than those with the bipolar subtype but this was not significant (g = 0.25, p = 0.05).
Cognitive impairments increase in severity from bipolar disorder to schizoaffective disorder to schizophrenia. Differences between the subtypes of schizoaffective disorder suggest combining the subtypes of schizoaffective disorder may obscure a study's results and hamper efforts to understand the relationship between this disorder and schizophrenia or bipolar disorder.
精神分裂情感障碍的认知损伤的性质和程度尚不清楚。本研究的目的是描述精神分裂情感障碍的认知功能，并将其与精神分裂症和双相情感障碍的认知进行比较。精神分裂情感障碍被认为是一个单一的类别，以及其两个诊断亚型，双相和抑郁障碍。
在进行了全面的文献检索（确定了 468 条记录）后，我们纳入了 31 项研究，共纳入 1685 名精神分裂情感障碍患者、3357 名精神分裂症患者和 1095 名双相情感障碍患者。对七个认知变量进行了荟萃分析，比较了精神分裂情感障碍患者与精神分裂症患者之间的表现，以及精神分裂情感障碍与双相情感障碍患者之间的表现。
精神分裂情感障碍患者的表现比双相情感障碍患者差（g=-0.30），比精神分裂症患者好（g=0.17）。精神分裂情感障碍亚型的荟萃分析显示，抑郁型患者的认知损伤严重程度与精神分裂症患者相似（g=0.08），而双相型患者的认知损伤比双相情感障碍患者严重（g=-0.23），比精神分裂症患者轻（g=0.29）。抑郁型患者的表现比双相型患者差，但差异无统计学意义（g=0.25，p=0.05）。
认知损伤的严重程度从双相情感障碍到精神分裂情感障碍再到精神分裂症逐渐增加。精神分裂情感障碍亚型之间的差异表明，将精神分裂情感障碍的亚型合并可能会掩盖研究结果，并阻碍对该障碍与精神分裂症或双相情感障碍之间关系的理解。
