Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Department of Clinical Medicine, Copenhagen, Denmark.
Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark; Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark; University of Copenhagen, Faculty of Social Sciences, Department of Psychology, Copenhagen, Denmark.
Psychiatry Res. 2020 Dec;294:113498. doi: 10.1016/j.psychres.2020.113498. Epub 2020 Oct 4.
Impaired cognitive test performance is well-documented in subjects at ultra-high risk (UHR) for psychosis. However, assessment of cognitive deficits as manifested in real life is a neglected area of UHR research that may add to the understanding of cognitive impairment and its relationship with psychosocial functioning and positive symptomatology. This study applied the interview-based Schizophrenia Cognition Rating Scale (SCoRS) and the questionnaire-based Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A) in a cross-sectional sample of 39 UHR subjects and 50 healthy controls. Cognitive test performance, psychosocial functioning, and positive symptoms were also assessed. The UHR subjects demonstrated significant cognitive impairment, with large effect sizes for the SCoRS and BRIEF-A composite outcome variables (rs = -0.67 to -0.80) and a neurocognitive composite score (d = -0.97). Within the UHR group, several significant associations between worse cognitive ratings and worse cognitive test performance (rs = -0.210 to -0.343), poorer psychosocial functioning (rs = -0.058 to -0.728), and worse positive symptoms (rs= 0.415 to 0.478) were found. Worse cognitive test performance showed significant associations with more pronounced positive symptoms (rs = -0.299 to -0.457). Interview and questionnaire assessment may hold promise for supplementing traditional performance-based cognitive assessment in identifying treatment targets in the UHR population.
认知测试表现受损在精神病超高风险（UHR）人群中已有充分记录。然而，评估现实生活中的认知缺陷是 UHR 研究中被忽视的领域，这可能有助于加深对认知障碍及其与社会心理功能和阳性症状之间关系的理解。本研究在 39 名 UHR 受试者和 50 名健康对照者的横断面样本中应用了基于访谈的精神分裂症认知评定量表（SCoRS）和基于问卷的行为评定量表 - 成人版（BRIEF-A）。还评估了认知测试表现、社会心理功能和阳性症状。UHR 受试者表现出明显的认知障碍，SCoRS 和 BRIEF-A 综合结果变量（rs=-0.67 至-0.80）和神经认知综合评分（d=-0.97）的效应量较大。在 UHR 组中，认知评分较差与认知测试表现较差（rs=-0.210 至-0.343）、社会心理功能较差（rs=-0.058 至-0.728）和阳性症状较差（rs=0.415 至 0.478）之间存在一些显著关联。认知测试表现越差，阳性症状越明显（rs=-0.299 至-0.457）。访谈和问卷评估可能有希望补充传统的基于表现的认知评估，以确定 UHR 人群中的治疗目标。
