Wootton Olivia, Dalvie Shareefa, MacGinty Rae, Ngqengelele Linda, Susser Ezra S, Gur Ruben C, Stein Dan J
Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
UCT MRC Genomic and Precision Medicine Research Unit, Division of Human Genetics, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Acta Neuropsychiatr. 2023 Jun 21;37:e27. doi: 10.1017/neu.2023.28.
Cognitive dysfunction in schizophrenia may be assessed by measuring within-individual variability (WIV) in performance across a range of cognitive tests. Previous studies have found increased WIV in people with schizophrenia, but no studies have been conducted in low- to middle-income countries where the different sociocultural context may affect WIV. We sought to address this gap by exploring the relationship between WIV and a range of clinical and demographic variables in a large study of people with schizophrenia and matched controls in South Africa.
544 people with schizophrenia and 861 matched controls completed an adapted version of The University of Pennsylvania Computerized Neurocognitive Battery (PennCNB). Demographic and clinical information was collected using the Structured Clinical Interview for DSM-IV Diagnoses. Across-task WIV for performance speed and accuracy on the PennCNB was calculated. Multivariate linear regression was used to assess the relationship between WIV and a diagnosis of schizophrenia in the whole sample, and WIV and selected demographic and clinical variables in people with schizophrenia.
Increased WIV of performance speed across cognitive tests was significantly associated with a diagnosis of schizophrenia. In people with schizophrenia, increased speed WIV was associated with older age, a lower level of education and a lower score on the Global Assessment of Functioning scale. Increased accuracy WIV was significantly associated with a younger age in people with schizophrenia.
Measurements of WIV of performance speed can add to the knowledge gained from studies of cognitive dysfunction in schizophrenia in resource-limited settings.
精神分裂症的认知功能障碍可通过测量一系列认知测试中个体内部的表现变异性（WIV）来评估。先前的研究发现精神分裂症患者的WIV增加，但尚未在不同社会文化背景可能影响WIV的低收入和中等收入国家进行过研究。我们试图通过在南非对大量精神分裂症患者和匹配对照组进行研究，探索WIV与一系列临床和人口统计学变量之间的关系，以填补这一空白。
544名精神分裂症患者和861名匹配对照组完成了宾夕法尼亚大学计算机化神经认知测试电池（PennCNB）的改编版。使用《精神疾病诊断与统计手册》第四版（DSM-IV）结构化临床访谈收集人口统计学和临床信息。计算了PennCNB上表现速度和准确性的跨任务WIV。采用多元线性回归评估整个样本中WIV与精神分裂症诊断之间的关系，以及精神分裂症患者中WIV与选定的人口统计学和临床变量之间的关系。
认知测试中表现速度的WIV增加与精神分裂症诊断显著相关。在精神分裂症患者中，速度WIV增加与年龄较大、教育水平较低以及功能总体评估量表得分较低有关。准确性WIV增加与精神分裂症患者年龄较小显著相关。
在资源有限的环境中，对表现速度的WIV测量可以增加从精神分裂症认知功能障碍研究中获得的知识。
