Orygen, Melbourne, Victoria, Australia.
Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia.
Psychol Med. 2023 Oct;53(13):5945-5957. doi: 10.1017/S0033291723001770. Epub 2023 Jul 6.
Studies investigating cognitive impairments in psychosis and depression have typically compared the average performance of the clinical group against healthy controls (HC), and do not report on the actual of cognitive impairments or strengths within these clinical groups. This information is essential so that clinical services can provide adequate resources to supporting cognitive functioning. Thus, we investigated this prevalence in individuals in the early course of psychosis or depression.
A comprehensive cognitive test battery comprising 12 tests was completed by 1286 individuals aged 15-41 (mean age 25.07, s.d. 5.88) from the PRONIA study at baseline: HC ( = 454), clinical high risk for psychosis (CHR; = 270), recent-onset depression (ROD; = 267), and recent-onset psychosis (ROP; = 295). Z-scores were calculated to estimate the prevalence of moderate or severe deficits or strengths (>2 s.d. or 1-2 s.d. below or above HC, respectively) for each cognitive test.
Impairment in at least two cognitive tests was as follows: ROP (88.3% moderately, 45.1% severely impaired), CHR (71.2% moderately, 22.4% severely impaired), ROD (61.6% moderately, 16.2% severely impaired). Across clinical groups, impairments were most prevalent in tests of working memory, processing speed, and verbal learning. Above average performance (>1 s.d.) in at least two tests was present for 40.5% ROD, 36.1% CHR, 16.1% ROP, and was >2 SDs in 1.8% ROD, 1.4% CHR, and 0% ROP.
These findings suggest that interventions should be tailored to the individual, with working memory, processing speed, and verbal learning likely to be important transdiagnostic targets.
研究精神分裂症和抑郁症中的认知障碍通常将临床组的平均表现与健康对照组（HC）进行比较，而不报告这些临床组中认知障碍或优势的实际 。这一信息至关重要，以便临床服务能够提供足够的资源来支持认知功能。因此，我们调查了处于精神分裂症或抑郁症早期阶段的个体的这种患病率。
PRONIA 研究在基线时完成了由 1286 名年龄在 15-41 岁之间的个体（平均年龄 25.07，标准差 5.88）组成的综合认知测试电池，包括 12 项测试：HC（n=454）、精神病高危（CHR；n=270）、近期发病抑郁症（ROD；n=267）和近期发病精神分裂症（ROP；n=295）。计算 Z 分数以估计每个认知测试中度或严重缺陷或优势（分别为 >2 s.d. 或 1-2 s.d. 低于或高于 HC）的患病率。
至少有两项认知测试受损如下：ROP（88.3%中度，45.1%严重受损）、CHR（71.2%中度，22.4%严重受损）、ROD（61.6%中度，16.2%严重受损）。在所有临床组中，工作记忆、处理速度和言语学习方面的测试最常见受损。至少有两项测试表现优于平均水平（>1 s.d.），ROP 组为 40.5%，CHR 组为 36.1%，ROP 组为 16.1%，ROC 组为 1.8%，CHR 组为 1.4%，ROP 组为 0%。
这些发现表明，干预措施应针对个体进行定制，工作记忆、处理速度和言语学习可能是重要的跨诊断目标。
