Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy.
Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy.
Schizophr Res. 2021 Oct;236:69-79. doi: 10.1016/j.schres.2021.08.008. Epub 2021 Aug 14.
Premorbid functioning and cognitive measures may reflect gradients of developmental impairment across diagnostic categories in psychosis. In this study, we sought to examine the associations of current cognition and premorbid adjustment with symptom dimensions in a large first episode psychosis (FEP) sample. We used data from the international EU-GEI study. Bifactor modelling of the Operational Criteria in Studies of Psychotic Illness (OPCRIT) ratings provided general and specific symptom dimension scores. Premorbid Adjustment Scale estimated premorbid social (PSF) and academic adjustment (PAF), and WAIS-brief version measured IQ. A MANCOVA model examined the relationship between symptom dimensions and PSF, PAF, and IQ, having age, sex, country, self-ascribed ethnicity and frequency of cannabis use as confounders. In 785 patients, better PSF was associated with fewer negative (B = -0.12, 95% C.I. -0.18, -0.06, p < 0.001) and depressive (B = -0.09, 95% C.I. -0.15, -0.03, p = 0.032), and more manic (B = 0.07, 95% C.I. 0.01, 0.14, p = 0.023) symptoms. Patients with a lower IQ presented with slightly more negative and positive, and fewer manic, symptoms. Secondary analysis on IQ subdomains revealed associations between better perceptual reasoning and fewer negative (B = -0.09, 95% C.I. -0.17, -0.01, p = 0.023) and more manic (B = 0.10, 95% C.I. 0.02, 0.18, p = 0.014) symptoms. Fewer positive symptoms were associated with better processing speed (B = -0.12, 95% C.I. -0.02, -0.004, p = 0.003) and working memory (B = -0.10, 95% C.I. -0.18, -0.01, p = 0.024). These findings suggest that the negative and manic symptom dimensions may serve as clinical proxies of different neurodevelopmental predisposition in psychosis.
病前功能和认知测量可能反映出精神病诊断类别中的发育障碍程度。在这项研究中，我们试图在一个大型首发精神病（FEP）样本中检查当前认知和病前调整与症状维度的关联。我们使用了国际 EU-GEI 研究的数据。使用操作性精神疾病研究标准（OPCRIT）评分的双因素模型提供了一般和特定的症状维度评分。病前调整量表（PSF）和学术调整量表（PAF）估计了病前的社会适应能力和学业适应能力，WAIS 简短版本测量了智商。MANCOVA 模型检验了症状维度与 PSF、PAF 和智商之间的关系，将年龄、性别、国家、自我认定的种族和大麻使用频率作为混杂因素。在 785 名患者中，更好的 PSF 与更少的阴性（B = -0.12，95%置信区间 -0.18，-0.06，p < 0.001）和抑郁（B = -0.09，95%置信区间 -0.15，-0.03，p = 0.032）症状有关，而更多的躁狂（B = 0.07，95%置信区间 0.01，0.14，p = 0.023）症状有关。智商较低的患者表现出稍多的阴性和阳性症状，以及较少的躁狂症状。对智商子域的二次分析显示，更好的知觉推理与更少的阴性（B = -0.09，95%置信区间 -0.17，-0.01，p = 0.023）和更多的躁狂（B = 0.10，95%置信区间 0.02，0.18，p = 0.014）症状有关。较少的阳性症状与更好的加工速度（B = -0.12，95%置信区间 -0.02，-0.004，p = 0.003）和工作记忆（B = -0.10，95%置信区间 -0.18，-0.01，p = 0.024）有关。这些发现表明，阴性和躁狂症状维度可能是精神病中不同神经发育倾向的临床代表。
