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精神分裂症早期的形式思维障碍、神经认知与功能的关系:过去半个世纪研究的系统综述。

Association between formal thought disorders, neurocognition and functioning in the early stages of psychosis: a systematic review of the last half-century studies.

机构信息

Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Nussbaumstr. 7, 80336, Munich, Germany.

International Max Planck Research School for Translational Psychiatry, Munich, Germany.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2022 Apr;272(3):381-393. doi: 10.1007/s00406-021-01295-3. Epub 2021 Jul 14.

Abstract

Recent review articles provided an extensive collection of studies covering many aspects of format thought disorders (FTD) among their epidemiology and phenomenology, their neurobiological underpinnings, genetics as well as their transdiagnostic prevalence. However, less attention has been paid to the association of FTD with neurocognitive and functioning deficits in the early stages of evolving psychosis. Therefore, this systematic review aims to investigate the state of the art regarding the association between FTD, neurocognition and functioning in the early stages of evolving psychotic disorders in adolescents and young adults, by following the PRISMA flowchart. A total of 106 studies were screened. We included 8 studies due to their reports of associations between FTD measures and functioning outcomes measured with different scales and 7 studies due to their reports of associations between FTD measures and neurocognition. In summary, the main findings of the included studies for functioning outcomes showed that FTD severity predicted poor social functioning, unemployment, relapses, re-hospitalisations, whereas the main findings of the included studies for neurocognition showed correlations between attentional deficits, executive functions and FTD, and highlighted the predictive potential of executive dysfunctions for sustained FTD. Further studies in upcoming years taking advantage of the acceleration in computational psychiatry would allow researchers to re-investigate the clinical importance of FTD and their role in the transition from at-risk to full-blown psychosis conditions. Employing automated computer-assisted diagnostic tools in the early stages of psychosis might open new avenues to develop targeted neuropsychotherapeutics specific to FTD.

摘要

最近的综述文章广泛收集了涵盖格式思维障碍(FTD)在流行病学和现象学、神经生物学基础、遗传学以及跨诊断流行率等方面的研究。然而,对于 FTD 与发展中的精神病早期神经认知和功能缺陷的关联,关注较少。因此,本系统综述旨在按照 PRISMA 流程图,调查青少年和年轻成人发展中的精神病早期 FTD、神经认知和功能之间关联的最新研究状况。共筛选出 106 项研究。我们纳入了 8 项研究,因为它们报告了 FTD 测量值与不同量表测量的功能结果之间的关联;纳入了 7 项研究,因为它们报告了 FTD 测量值与神经认知之间的关联。总之,纳入的功能结果研究的主要发现表明,FTD 严重程度预测社会功能不良、失业、复发、再住院,而纳入的神经认知研究的主要发现表明注意力缺陷、执行功能与 FTD 之间存在相关性,并强调了执行功能障碍对持续 FTD 的预测潜力。未来几年,利用计算精神病学的加速发展,研究人员将能够重新研究 FTD 的临床重要性及其在从高危到全面精神病状态转变中的作用。在精神病早期使用自动化计算机辅助诊断工具可能为开发针对 FTD 的特定神经心理治疗开辟新途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a35/8938342/c7e1b9df5fa2/406_2021_1295_Fig1_HTML.jpg

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