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欧洲精神病学协会关于精神分裂症认知障碍评估的指南。

European Psychiatric Association guidance on assessment of cognitive impairment in schizophrenia.

机构信息

Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Department of Mental Health and Addiction Services, Spedali Civili Hospital, Brescia, Italy.

出版信息

Eur Psychiatry. 2022 Sep 5;65(1):e58. doi: 10.1192/j.eurpsy.2022.2316.

Abstract

BACKGROUND

Impairment in a wide range of cognitive abilities has been consistently reported in individuals with schizophrenia. Both neurocognitive and social cognitive deficits are thought to underlie severe functional disabilities associated with schizophrenia. Despite the key role in schizophrenia outcome, cognition is still poorly assessed in both research and clinical settings.

METHODS

In this guidance paper, we provide a systematic review of the scientific literature and elaborate several recommendations for the assessment of cognitive functions in schizophrenia both in research settings and in real-world clinical practice.

RESULTS

Expert consensus and systematic reviews provided guidance for the optimal assessment of cognitive functions in schizophrenia. Based on the reviewed evidence, we recommend a comprehensive and systematic assessment of neurocognitive and social cognitive domains in schizophrenia, in all phases of the disorder, as well as in subjects at risk to develop psychosis. This European Psychiatric Association guidance recommends not only the use of observer reports but also self-reports and interview-based cognitive assessment tools. The guidance also provides a systematic review of the state of the art of assessment in the first episode of psychosis patients and in individuals at risk for psychosis.

CONCLUSION

The comprehensive review of the evidence and the recommendations might contribute to advance the field, allowing a better cognitive assessment, and avoiding overlaps with other psychopathological dimensions. The dissemination of this guidance paper may promote the development of shared guidelines concerning the assessment of cognitive functions in schizophrenia, with the purpose to improve the quality of care and to obtain recovery.

摘要

背景

精神分裂症患者的认知能力受损范围广泛,这一现象已得到一致报道。神经认知和社会认知缺陷被认为是与精神分裂症相关的严重功能障碍的基础。尽管认知能力在精神分裂症的结果中起着关键作用,但在研究和临床环境中,对其的评估仍然很差。

方法

在本指导文件中,我们对科学文献进行了系统回顾,并详细阐述了在研究环境和真实临床实践中评估精神分裂症认知功能的若干建议。

结果

专家共识和系统评价为精神分裂症认知功能的最佳评估提供了指导。基于已审查的证据,我们建议在疾病的所有阶段以及有发生精神病风险的受试者中,对神经认知和社会认知领域进行全面系统的评估。该欧洲精神病学协会指南不仅建议使用观察者报告,还建议使用自我报告和基于访谈的认知评估工具。该指南还对精神病首次发作患者和有精神病风险个体的评估现状进行了系统回顾。

结论

对证据的全面回顾和建议可能有助于推动该领域的发展,从而实现更好的认知评估,并避免与其他精神病理学维度重叠。本指导文件的传播可能会促进制定有关精神分裂症认知功能评估的共识指南,以提高护理质量并获得康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e45/9532219/829191a98adb/S0924933822023161_fig1.jpg

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