Karcher Nicole R, Merchant Jaisal, Pine Jacob, Kilciksiz Can Misel
Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
Department of Brain and Psychological Sciences, Washington University in St. Louis, St. Louis, MO, USA.
Curr Top Behav Neurosci. 2023;63:173-203. doi: 10.1007/7854_2022_387.
The current chapter summarizes recent evidence for cognition as a risk factor for the development of psychosis, including the range of cognitive impairments that exist across the spectrum of psychosis risk symptoms. The chapter examines several possible theories linking cognitive deficits with the development of psychotic symptoms, including evidence that cognitive deficits may be an intermediate risk factor linking genetic and/or neural metrics to psychosis spectrum symptoms. Although there is not strong evidence for unique cognitive markers associated specifically with psychosis compared to other forms of psychopathology, psychotic disorders are generally associated with the greatest severity of cognitive deficits. Cognitive deficits precede the development of psychotic symptoms and may be detectable as early as childhood. Across the psychosis spectrum, both the presence and severity of psychotic symptoms are associated with mild to moderate impairments across cognitive domains, perhaps most consistently for language, cognitive control, and working memory domains. Research generally indicates the size of these cognitive impairments worsens as psychosis symptom severity increases. The chapter points out areas of unclarity and unanswered questions in each of these areas, including regarding the mechanisms contributing to the association between cognition and psychosis, the timing of deficits, and whether any cognitive systems can be identified that function as specific predictors of psychosis risk symptoms.
本章总结了近期有关认知作为精神病发生风险因素的证据，包括存在于精神病风险症状谱中的一系列认知障碍。本章探讨了将认知缺陷与精神病性症状发生联系起来的几种可能理论，包括认知缺陷可能是将遗传和/或神经指标与精神病谱症状联系起来的中间风险因素的证据。尽管与其他形式的精神病理学相比，没有强有力的证据表明存在专门与精神病相关的独特认知标志物，但精神病性障碍通常与最严重的认知缺陷相关。认知缺陷先于精神病性症状出现，甚至早在儿童期就可能被检测到。在整个精神病谱中，精神病性症状的存在和严重程度都与认知领域的轻度至中度损害相关，可能在语言、认知控制和工作记忆领域最为一致。研究普遍表明，随着精神病症状严重程度的增加，这些认知障碍的程度会恶化。本章指出了这些领域中不明确和未解答的问题，包括认知与精神病之间关联的机制、缺陷出现的时间，以及是否能识别出任何作为精神病风险症状特定预测指标的认知系统。
