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难治性精神分裂症患者的言语和视觉学习能力:一项为期1年的随访研究。

Verbal and visual learning ability in patients with treatment-resistant schizophrenia: A 1-year follow-up study.

作者信息

Arnautovska Urska, Vitangcol Kathryn, Kesby James P, Warren Nicola, Rossell Susan L, Neill Erica, Harris Anthony, Galletly Cherrie, Castle David, Siskind Dan

机构信息

Faculty of Medicine, University of Queensland, Brisbane, QLD 4102, Australia.

Metro South Addictions and Mental Health Service, Woolloongabba, QLD 4102, Australia.

出版信息

Schizophr Res Cogn. 2023 Mar 28;33:100283. doi: 10.1016/j.scog.2023.100283. eCollection 2023 Sep.

Abstract

OBJECTIVE

In the general population, repeated cognitive testing produces learning effects with potential for improved test performance. It is currently unclear whether the same effect of repeated cognitive testing on cognition pertains to people living with schizophrenia, a condition often associated with significant cognitive impairments. This study aims to evaluate learning ability in people with schizophrenia and-considering the evidence that antipsychotic medication can additionally impair cognitive performance-explore the potential impact of anticholinergic burden on verbal and visual learning.

METHOD

The study included 86 patients with schizophrenia, treated with clozapine, who had persisting negative symptoms. They were assessed at baseline, weeks 8, 24 and 52 using Positive and Negative Syndrome Scale, Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-R (BVMT-R).

RESULTS

There were no significant improvements in verbal or visual learning across all measurements. Neither the clozapine/norclozapine ratio nor anticholinergic cognitive burden significantly predicted participants' total learning. Premorbid IQ was significantly associated with verbal learning on the HVLT-R.

CONCLUSIONS

These findings advance our understanding of cognitive performance in people with schizophrenia and demonstrate limited learning performance in individuals with treatment-refractory schizophrenia.

摘要

目的

在普通人群中,重复进行认知测试会产生学习效应,有可能提高测试成绩。目前尚不清楚重复认知测试对认知的同样影响是否适用于精神分裂症患者,这种疾病通常与显著的认知障碍有关。本研究旨在评估精神分裂症患者的学习能力,并考虑到抗精神病药物会额外损害认知表现的证据,探讨抗胆碱能负担对言语和视觉学习的潜在影响。

方法

该研究纳入了86例使用氯氮平治疗且存在持续阴性症状的精神分裂症患者。在基线、第8周、第24周和第52周使用阳性和阴性症状量表、修订版霍普金斯言语学习测试(HVLT-R)和简短视觉空间记忆测试-R(BVMT-R)对他们进行评估。

结果

在所有测量中,言语或视觉学习均无显著改善。氯氮平/去甲氯氮平比率和抗胆碱能认知负担均未显著预测参与者的总体学习情况。病前智商与HVLT-R上的言语学习显著相关。

结论

这些发现增进了我们对精神分裂症患者认知表现的理解,并证明难治性精神分裂症患者的学习表现有限。

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Neural Circuitry of Salience and Reward Processing in Psychosis.精神病中显著性和奖赏处理的神经回路
Biol Psychiatry Glob Open Sci. 2021 Dec 11;3(1):33-46. doi: 10.1016/j.bpsgos.2021.12.003. eCollection 2023 Jan.
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Anticholinergic Medication Burden-Associated Cognitive Impairment in Schizophrenia.精神分裂症中抗胆碱能药物负担相关的认知障碍
Am J Psychiatry. 2021 Sep 1;178(9):838-847. doi: 10.1176/appi.ajp.2020.20081212. Epub 2021 May 14.
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Clinical indicators of treatment-resistant psychosis.治疗抵抗性精神病的临床指标。
Br J Psychiatry. 2020 May;216(5):259-266. doi: 10.1192/bjp.2019.120.

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