认知障碍与乌干达首发精神病患者的生活质量和功能障碍的关系：一项横断面研究。
The association of cognitive impairment with quality of life and functional impairment in Ugandan first-episode psychosis patients: a cross sectional study.
机构信息
Department of Psychiatry, Makerere University, Kampala, Uganda.
Butabika National Referral Mental and Teaching Hospital, Kampala, Uganda.
出版信息
Health Qual Life Outcomes. 2022 Jul 23;20(1):113. doi: 10.1186/s12955-022-02020-x.
INTRODUCTION
Cognitive impairment is common in first-episode psychosis patients and often associated with poor quality of life and functional impairment. However, most literature on this association is from high income countries and not low resource countries like Uganda. We aimed to determine the association between cognitive impairment with quality of life and functional impairment in Ugandan first-episode psychosis patients.
METHODS
At Butabika national psychiatric hospital of Uganda, we enrolled 94 first-episode psychosis patients aged 18-60 years with a confirmed first-episode of psychosis and no previous treatment with antipsychotic medication. Neuropsychological assessment was performed using the MATRICS consensus cognitive battery (MCCB). Quality of life and functional impairment were assessed using the brief version of the World Health Organisation Quality of Life scale (WHOQOL-BREF) and the MINI International Neuropsychiatric Inventory (MINI) respectively. Linear regression analyses determined the association between impairment in different cognitive domains with various quality of life and functional impairment domains while controlling for age, gender and level of education.
RESULTS
High scores in the reasoning and problem solving cognitive domain were associated with better quality of life in the psychological domain of WHOQOL-BREF (p = 0.029). For functional impairment, high cognitive scores in the domains of speed of processing (p = 0.018), reasoning and problem solving (p = 0.015), working memory (p = 0.017) and visual learning and memory (p = 0.002) were associated with psychosis "having a greater impact on other members of the family" on the MINI. Higher scores in the social cognition domain were associated with "less aggressive and disruptive behaviour" (p = 0.003).
CONCLUSION
Cognitive impairment in Ugandan first-episode psychotic patients is associated with both poorer quality of life and functional impairment. Remediation of cognitive function may be a plausible intervention to improve outcomes in Ugandan first-episode psychosis patients.
简介
认知障碍在首发精神分裂症患者中很常见，常与生活质量差和功能障碍有关。然而，大多数关于这种关联的文献来自高收入国家，而不是像乌干达这样的低资源国家。我们旨在确定乌干达首发精神分裂症患者认知障碍与生活质量和功能障碍的关系。
方法
在乌干达布塔比卡国家精神病院，我们招募了 94 名年龄在 18-60 岁之间的首发精神分裂症患者，他们患有确诊的首发精神分裂症，且以前没有服用过抗精神病药物。使用 MATRICS 共识认知电池 (MCCB) 进行神经心理评估。使用世界卫生组织生活质量量表（WHOQOL-BREF）简短版和 Mini 国际神经精神访谈（MINI）分别评估生活质量和功能障碍。线性回归分析确定了不同认知领域的损伤与各种生活质量和功能障碍领域之间的关系，同时控制年龄、性别和教育水平。
结果
推理和问题解决认知领域的高分与 WHOQOL-BREF 心理领域的生活质量较高相关（p=0.029）。对于功能障碍，速度处理（p=0.018）、推理和问题解决（p=0.015）、工作记忆（p=0.017）和视觉学习和记忆（p=0.002）领域的认知评分较高与 MINI 中的“对家庭其他成员的影响更大”有关。社会认知领域的较高分数与“较少的攻击性和破坏性行为”相关（p=0.003）。
结论
乌干达首发精神分裂症患者的认知障碍与生活质量和功能障碍均较差有关。认知功能的改善可能是改善乌干达首发精神分裂症患者结局的合理干预措施。
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