Yin Yi, Li Shuangshuang, Tong Jinghui, Huang Junchao, Tian Baopeng, Chen Song, Cui Yimin, Tan Shuping, Wang Zhiren, Yang Fude, Tong Yongsheng, Hong L Elliot, Tan Yunlong
Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China.
Department of Pharmacy, Peking University First Hospital, Beijing, People's Republic of China.
Cogn Neurodyn. 2023 Feb;17(1):183-190. doi: 10.1007/s11571-022-09814-1. Epub 2022 May 26.
In schizophrenia, the age of first episode onset can reflect genetic loading and predict prognosis. Little is known about the association between the age of onset and cognition among individuals with early-stage schizophrenia. We aimed to compare the pre-treatment neurocognition profile between individuals with early-onset schizophrenia (EOS, the age of onset < 18 years), typical-onset schizophrenia (TOS, the age of onset between 18 and 39 years), and late-onset schizophrenia (LOS, the age of onset between 40 and 59 years). We included individuals with a current diagnosis of schizophrenia within 3 years and medication naive or less than 2 weeks of cumulative antipsychotic exposure and current daily antipsychotic dosage equivalent to ≤ 15 mg of olanzapine. Assessments included the MATRICS Consensus Cognitive Battery (MCCB) and the Positive and Negative Syndrome Scale (PANSS). We used linear regression to compare the difference between age-of-onset groups. We included 356 participants (67 EOS, 195 TOS, and 94 LOS). Compared with LOS, TOS was associated with lower scores in the verbal learning scores of the MCCB after adjusting for education years and the subscale scores of the PANSS (45.5 ± 12.9 vs. 40.5 ± 14.1, adjusted = - 5.79, = 0.001). The three groups had no difference in other cognitive domain scores. The association between the age of onset and MCCB verbal memory was U-shape (square of the age of onset, adjusted = 0.02, = 0.003). Patients with LOS had a better verbal learning function compared with individuals with TOS. These findings suggest that involvement of cognition assessment and rehabilitation training is necessary for patients with TOS.
在精神分裂症中，首次发作年龄可反映遗传负荷并预测预后。对于早期精神分裂症患者，发病年龄与认知之间的关联知之甚少。我们旨在比较早发性精神分裂症（EOS，发病年龄<18岁）、典型发病精神分裂症（TOS，发病年龄在18至39岁之间）和晚发性精神分裂症（LOS，发病年龄在40至59岁之间）患者治疗前的神经认知特征。我们纳入了在3年内确诊为精神分裂症且未服用过药物或累积抗精神病药物暴露少于2周、当前每日抗精神病药物剂量相当于≤15mg奥氮平的患者。评估包括MATRICS共识认知成套测验（MCCB）和阳性与阴性症状量表（PANSS）。我们使用线性回归比较发病年龄组之间的差异。我们纳入了356名参与者（67名EOS、195名TOS和94名LOS）。在校正受教育年限和PANSS分量表得分后，与LOS相比，TOS在MCCB言语学习得分上较低（45.5±12.9 vs. 40.5±14.1，校正后=-5.79，P=0.001）。三组在其他认知领域得分上无差异。发病年龄与MCCB言语记忆之间的关联呈U形（发病年龄的平方，校正后P=0.02，P=0.003）。与TOS患者相比，LOS患者具有更好的言语学习功能。这些发现表明，TOS患者有必要进行认知评估和康复训练。
