Departement of Neuroscience "Rita Levi Montalcini", University of Turin, Italy; Struttura Complessa di Psichiatria Universitaria, Dipartimento di Neuroscienze e Salute Mentale, Azienda Ospedaliero-Universitaria "Città della Salute e della Scienza di Torino", Turin, Italy.
Departement of Neuroscience "Rita Levi Montalcini", University of Turin, Italy; Struttura Complessa di Psichiatria Universitaria, Dipartimento di Neuroscienze e Salute Mentale, Azienda Ospedaliero-Universitaria "Città della Salute e della Scienza di Torino", Turin, Italy.
Schizophr Res. 2023 Jun;256:8-16. doi: 10.1016/j.schres.2023.04.011. Epub 2023 Apr 28.
Many illness-related factors contribute to the reduction of the real-life functioning observed in people with schizophrenia (SZ). These include the psychopathological dimensions of the disorder such as positive, negative, disorganization, and depressive symptoms as well as impairment in neurocognition, social cognition, and metacognition. The associations between some of these variables change with the duration of illness (DOI), but this aspect was not explored with a network approach. This study aimed at describing and comparing the inter-relationships between psychopathological, cognitive, and functioning variables in early (DOI ≤ 5 years) and late (DOI > 5 years) phase SZ with network analyses and at assessing which variables were more strictly and directly associated with the real-life functioning. A network representation of the relationships between variables and the calculation of centrality indices were performed within each group. The two groups were compared with a network comparison test. Seventy-five patients with early and ninety-two with late phase SZ were included. No differences in the global network structure and strength were found between the two groups. In both groups, visual learning and disorganization exhibited high centrality indices and disorganization, negative symptoms, and metacognition were directly and strongly associated with real-life functioning. In conclusion, regardless of the DOI, a rehabilitation aimed at improving visual learning and disorganization (i.e., the most central variables) might reduce the strength of the associations that compose the network and therefore indirectly facilitate functional recovery. Simultaneously, therapeutic interventions targeting disorganization and metacognition might directly improve real-life functioning.
许多与疾病相关的因素导致精神分裂症（SZ）患者的现实生活功能下降。这些因素包括疾病的心理病理学维度，如阳性、阴性、紊乱和抑郁症状，以及神经认知、社会认知和元认知的损伤。这些变量中的一些与疾病持续时间（DOI）有关，但这方面尚未通过网络方法进行探讨。本研究旨在通过网络分析描述和比较早期（DOI≤5 年）和晚期（DOI>5 年）SZ 患者的心理病理学、认知和功能变量之间的相互关系，并评估哪些变量与现实生活功能的关系更严格和直接。在每个组中都进行了变量之间关系的网络表示和中心性指数的计算。然后，使用网络比较检验比较了两组。共纳入 75 例早期 SZ 患者和 92 例晚期 SZ 患者。两组之间的整体网络结构和强度没有差异。在两组中，视觉学习和紊乱表现出较高的中心性指数，而紊乱、阴性症状和元认知与现实生活功能直接且强烈相关。总之，无论 DOI 如何，旨在改善视觉学习和紊乱（即最中心的变量）的康复治疗可能会降低组成网络的关联的强度，从而间接促进功能恢复。同时，针对紊乱和元认知的治疗干预可能会直接改善现实生活功能。
