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早发性慢性精神分裂症的执行功能缺陷是否比成人起病的慢性精神分裂症更严重?

Are Executive Functions Deficits in Early-Onset Chronic Schizophrenia More Severe than in Adult-Onset Chronic Schizophrenia?

作者信息

Hintze Beata, Rowicka Magdalena, Barczak Anna

机构信息

Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland.

Rare Diseases Research Platform, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland.

出版信息

Clin Neuropsychiatry. 2022 Feb;19(1):54-63. doi: 10.36131/cnfioritieditore20220108.

Abstract

OBJECTIVE

The research on the age of schizophrenia onset and cognitive impairments leads to contradictory conclusions. It is still unknown whether neurocognitive deficits in early-onset schizophrenia (EOS) are more intense than adulthood-onset schizophrenia (AOS). The study aimed to examine specific aspects of the executive functions of chronic outpatients with different ages of schizophrenia onset.

METHOD

Two clinical groups (EOS and AOS) consisted of 60 chronic outpatients with schizophrenia recruited from the community-based support system. The executive functions were measured with the Wisconsin Card Sorting Test (WCST), Trail Making Test A&B (TMT A&B), verbal fluency task (VFT), and the N-back test. Obtained results were compared to control groups consisting of 40 healthy subjects, matched with age, sex, and years of education, respectively.

RESULTS

There were no differences in various aspects of executive dysfunctions between EOS and AOS outpatients. The outpatients in general, had lower scores than healthy controls regardless of their age of symptom onset. The most important finding suggests that some cognitive domains (visual working memory and processing speed) in presented schizophrenia patients were similar to those in healthy controls.Despite the demographic differences, both clinical groups present the same level of executive functioning. In addition, similar to the healthy participants, the outpatients had no problems in working memory and processing speed.

CONCLUSIONS

These observations suggest that EOS might not be associated with more severe cognitive deterioration. Moreover, the stabilization or improvement of their functioning might be linked with long-term psycho-social rehabilitation and modern pharmacotherapy.

摘要

目的

关于精神分裂症发病年龄与认知障碍的研究得出了相互矛盾的结论。早发性精神分裂症(EOS)的神经认知缺陷是否比成年期发病的精神分裂症(AOS)更严重,目前仍不清楚。本研究旨在探讨不同发病年龄的慢性精神分裂症门诊患者执行功能的具体方面。

方法

两个临床组(EOS组和AOS组)由60名从社区支持系统招募的慢性精神分裂症门诊患者组成。采用威斯康星卡片分类测验(WCST)、连线测验A和B(TMT A&B)、言语流畅性任务(VFT)和N-back测验来测量执行功能。将所得结果与分别由40名年龄、性别和受教育年限相匹配的健康受试者组成的对照组进行比较。

结果

EOS组和AOS组门诊患者在执行功能障碍的各个方面没有差异。总体而言,无论症状发作年龄如何,门诊患者的得分均低于健康对照组。最重要的发现表明,所呈现的精神分裂症患者的某些认知领域(视觉工作记忆和处理速度)与健康对照组相似。尽管存在人口统计学差异,但两个临床组的执行功能水平相同。此外,与健康参与者相似,门诊患者在工作记忆和处理速度方面没有问题。

结论

这些观察结果表明,EOS可能与更严重的认知衰退无关。此外,其功能的稳定或改善可能与长期的心理社会康复和现代药物治疗有关。

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