Douglas Mental Health University Institute, McGill University, 6875 LaSalle Blvd.,Verdun, Montreal, Quebec H4H 1R3, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
The Royal's Institute of Mental Health Research, Ottawa, Canada.
Eur Neuropsychopharmacol. 2021 Jun;47:86-97. doi: 10.1016/j.euroneuro.2021.02.008. Epub 2021 Mar 2.
Negative symptoms are present at the onset of psychosis and their persistence is significantly associated with poor psychosocial functioning and lower quality of life. Persistent negative symptoms (PNS) may be idiopathic or secondary to other factors such as depression, positive symptoms, and medication side-effects. Several studies have examined neurocognitive functions in early psychosis patients with PNS relative to non-PNS, but have not systematically controlled for secondary PNS (sPNS). The latter may have a distinct neurocognitive profile that could obscure differences between PNS and non-PNS. Using a large (n = 425) sample, we examined neurocognitive functions in PNS, sPNS, and non-PNS and hypothesized that PNS would be associated with greater impairments relative to non-PNS. Following admission to an early intervention program, a neurocognitive battery was administered after at least 3 months of treatment, and symptom data collected during a subsequent 6-month period were used to classify patients as PNS, sPNS and non-PNS. At month 12, both PNS and sPNS groups had significantly lower level of functioning relative to the non-PNS group but the sPNS group experienced higher levels of depressive and positive symptoms and were on a higher dose of antipsychotics. Relative to non-PNS, PNS patients exhibited significant impairments in verbal memory and working memory, whereas sPNS patients exhibited a trend towards greater impairments in verbal memory. This study confirms that the presence of PNS or sPNS negatively influences functioning with more selective cognitive impairments found in PNS, providing evidence that these groups of patients could benefit from different personalised interventions.
阴性症状出现在精神病发作时，其持续存在与较差的社会心理功能和较低的生活质量显著相关。持续性阴性症状（PNS）可能是特发性的，也可能是由其他因素引起的，如抑郁、阳性症状和药物副作用。一些研究已经检查了 PNS 与非 PNS 的早期精神病患者的神经认知功能，但没有系统地控制继发性 PNS（sPNS）。后者可能具有独特的神经认知特征，这可能会掩盖 PNS 和非 PNS 之间的差异。使用一个大型（n=425）样本，我们检查了 PNS、sPNS 和非 PNS 的神经认知功能，并假设 PNS 与非 PNS 相比会有更大的损伤。在进入早期干预计划后，在至少 3 个月的治疗后进行神经认知测试，在随后的 6 个月期间收集症状数据，以将患者分类为 PNS、sPNS 和非 PNS。在第 12 个月，PNS 和 sPNS 组的功能水平均明显低于非 PNS 组，但 sPNS 组的抑郁和阳性症状水平更高，且服用的抗精神病药物剂量更高。与非 PNS 相比，PNS 患者在言语记忆和工作记忆方面表现出显著的损伤，而 sPNS 患者在言语记忆方面表现出更大的损伤趋势。这项研究证实，PNS 或 sPNS 的存在会对功能产生负面影响，而 PNS 患者则会出现更严重的选择性认知损伤，这为这些患者群体可能受益于不同的个性化干预提供了证据。
