Mensi Martina Maria, Orlandi Marika, Casini Erica, Catalan Ana, de Pablo Gonzalo Salazar, Fusar-Poli Paolo, Borgatti Renato
Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100, Pavia, Italy.
Psychiatry Department, Facultad de Medicina y Odontología, Centro de Investigación en Red de Salud Menta (CIBERSAM), Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, University of the Basque Country UPV/EHU, Instituto de Salud Carlos III, Barakaldo, Bizkaia, Spain.
Child Adolesc Psychiatry Ment Health. 2023 Feb 8;17(1):22. doi: 10.1186/s13034-023-00567-1.
Once psychosis has set in, it is difficult for patients to achieve full recovery. Prevention of psychosis and early intervention are promising for improving the outcomes of this disorder. In the last two decades, neurocognition has been studied as a biomarker for clinical-high risk for psychosis (CHR-P). However, neurocognitive functioning has been under-investigated in adolescents.
We enrolled 116 adolescents from 12 to 17 years old (mean = 15.27, SD = 1.56; 76 females). This 3-year cohort study aimed to identify differences in neurocognitive and overall functioning in three groups of adolescent patients divided according to the semi-structured interview Comprehensive Assessment of At-Risk Mental States (CAARMS): adolescents with established psychosis, adolescents with CHR-P, and adolescents not meeting either criteria (non-CHR-P). To differentiate the profiles, clinicians administered cognitive evaluation and neuropsychological tasks. Moreover, they filled in scales to assess their global, social, and role functioning and a questionnaire to assess the severity of the disease.
We made a between-group comparison on neurocognitive measures and found that the CHR-P and the psychosis groups differed in processing speed (TMT-A; p = .002 in BVN categorial fluency (p = .018), and Rey-Osterrieth complex figure drawing from memory task (p = .014), with psychosis group showing worse performance. No differences emerged between non-CHR-P and CHR-P (p = .014) individuals. CHR-P had better functioning than the psychosis group but worse than the non-CHR-P one.
These results confirm that neurocognition can be a helpful biomarker in identifying specific subgroups of adolescents with emerging psychopathology and help clinicians develop stratified preventive approaches.
一旦精神病发作，患者很难实现完全康复。预防精神病和早期干预有望改善这种疾病的治疗结果。在过去二十年中，神经认知已被作为精神病临床高危（CHR-P）的生物标志物进行研究。然而，青少年的神经认知功能研究不足。
我们招募了116名12至17岁的青少年（平均年龄=15.27，标准差=1.56；76名女性）。这项为期3年的队列研究旨在确定根据半结构化访谈《高危精神状态综合评估》（CAARMS）划分的三组青少年患者在神经认知和整体功能方面的差异：已确诊精神病的青少年、CHR-P青少年以及不符合任何标准的青少年（非CHR-P）。为了区分这些特征，临床医生进行了认知评估和神经心理学测试。此外，他们填写了评估其整体、社交和角色功能的量表以及一份评估疾病严重程度的问卷。
我们对神经认知指标进行了组间比较，发现CHR-P组和精神病组在处理速度（TMT-A；p=0.002）、BVN分类流畅性（p=0.018）以及雷伊-奥斯特里赫复杂图形记忆任务（p=0.014）方面存在差异，精神病组表现更差。非CHR-P组和CHR-P组个体之间没有差异（p=0.014）。CHR-P组的功能比精神病组好，但比非CHR-P组差。
这些结果证实，神经认知可以作为一种有用的生物标志物，用于识别有新发精神病理学的青少年特定亚组，并帮助临床医生制定分层预防方法。
