Whitson Sarah, O'Donoghue Brian, Hester Robert, Baldwin Lara, Harrigan Susy, Francey Shona, Graham Jessica, Nelson Barnaby, Ratheesh Aswin, Alvarez-Jimenez Mario, Fornito Alex, Pantelis Christos, Yuen Hok Pan, Thompson Andrew, Kerr Melissa, Berk Michael, Wood Stephen J, McGorry Patrick, Allott Kelly
Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia.
Orygen, Parkville, VIC 3052, Australia.
Schizophr Res Cogn. 2021 Feb 13;24:100194. doi: 10.1016/j.scog.2021.100194. eCollection 2021 Jun.
Cognitive impairments are a core feature of first-episode psychosis (FEP), arising before illness onset and antipsychotic exposure. Individuals with chronic psychosis experience poorer physical health while taking antipsychotic medication, but health disparities may be evident at FEP onset, prior to antipsychotic exposure. Given the links between cognition and physical health in healthy populations, the aim was to explore whether cognition and physical health are associated in FEP, which could inform early physical health interventions for cognition in FEP. Participants were aged 15 to 25 and included 86 individuals experiencing FEP with limited antipsychotic exposure and duration of untreated psychosis of ≤six months, and 43 age- and sex-matched controls. Individuals with FEP performed significantly poorer than controls in most cognitive domains (Cohen's = 0.38 to 1.59). Groups were similar in metabolic health measures, excluding a significantly faster heart rate in FEP ( = 0.68). Through hierarchical regression analyses, we found that in the overall sample, BMI was negatively related to current IQ after controlling for education and group (FEP/control). Relationships between BMI and cognition were consistent across the FEP and healthy control groups. In FEP, current IQ and working memory were negatively correlated with lipid profiles. Findings suggest that in FEP, impaired cognition is exhibited earlier than physical health problems, and that compared to controls, similar relationships with cognition are demonstrated. Causal pathways and trajectories of relationships between health and cognition in FEP require investigation, especially as antipsychotic medications are introduced. The findings have implications for cognitive and health interventions.
认知障碍是首发精神病（FEP）的核心特征，在疾病发作和接触抗精神病药物之前就已出现。患有慢性精神病的个体在服用抗精神病药物期间身体健康状况较差，但在FEP发作时，即在接触抗精神病药物之前，健康差异可能就已明显。鉴于健康人群中认知与身体健康之间的联系，本研究旨在探讨FEP中认知与身体健康是否相关，这可为FEP认知方面的早期身体健康干预提供依据。研究参与者年龄在15至25岁之间，包括86名首次发作精神病且抗精神病药物接触有限、未治疗精神病持续时间≤6个月的个体，以及43名年龄和性别匹配的对照组。在大多数认知领域，FEP个体的表现明显比对照组差（科恩d值=0.38至1.59）。两组在代谢健康指标方面相似，但FEP组的心率明显更快（d值=0.68）。通过分层回归分析，我们发现，在总体样本中，控制教育程度和组别（FEP/对照组）后，体重指数与当前智商呈负相关。体重指数与认知之间的关系在FEP组和健康对照组中是一致的。在FEP组中，当前智商和工作记忆与血脂水平呈负相关。研究结果表明，在FEP中，认知障碍比身体健康问题出现得更早，并且与对照组相比，认知与健康之间呈现出相似的关系。FEP中健康与认知之间关系的因果途径和轨迹需要进一步研究，尤其是在引入抗精神病药物的情况下。这些发现对认知和健康干预具有启示意义。
