Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia.
Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey.
Schizophr Res. 2024 Apr;266:58-65. doi: 10.1016/j.schres.2024.02.012. Epub 2024 Feb 17.
BACKGROUND: Schizophrenia and bipolar disorder are associated with significant deficits in neurocognition and social cognition. Unlike the studies in chronic stages of these disorders, very limited information is available regarding neurocognitive and social-cognitive impairment before the onset of bipolar disorder. Our main aim was to investigate the differences in neurocognition and social cognition between individuals at ultra-high risk for psychosis (UHR-P) and bipolar disorder (UHR-BD). METHODS: This study included 152 help-seeking individuals identified as UHR-P (n = 78) and UHR-BD (n = 74), who were compared with a healthy control group (n = 43). A comprehensive neuropsychological battery was administered to all participants. RESULTS: UHR-P was associated with widespread deficits in all neurocognitive and social-cognitive domains. Effect sizes (Cohen's d) of these deficits ranged from -0.57 to -1.34. UHR-BD was associated with significant deficits in processing speed, executive functions, sustained attention and social cognition (d = -0.48 to-0.70, p < 0.05). UHR-P performed significantly worse than UHR-BD in social cognition, processing speed, verbal memory and executive function domains (d = -0.39 to-0.64, p < 0.05). Negative symptoms were associated with impaired social cognition in the UHR-P group and verbal memory deficits in the UHR-BD group. Cognitive impairment was associated with functional impairment in both groups. CONCLUSIONS: While UHR-P is associated with more widespread cognitive impairment, deficits in processing speed, executive functions, sustained attention and social cognition might be common features of both UHR groups. In early intervention services, cognition should be considered as a target for assessment and intervention not only for individuals at high risk for psychosis but also for bipolar disorder.
背景:精神分裂症和双相情感障碍与神经认知和社会认知的显著缺陷有关。与这些疾病慢性阶段的研究不同,关于双相情感障碍发病前的神经认知和社会认知损伤,信息非常有限。我们的主要目的是研究处于精神病超高危(UHR-P)和双相情感障碍(UHR-BD)状态的个体之间的神经认知和社会认知差异。
方法:本研究纳入了 152 名寻求帮助的个体,分为 UHR-P(n=78)和 UHR-BD(n=74),并与健康对照组(n=43)进行比较。所有参与者均接受了全面的神经心理学测试。
结果:UHR-P 与所有神经认知和社会认知领域的广泛缺陷有关。这些缺陷的效应大小(Cohen's d)范围为-0.57 至-1.34。UHR-BD 与处理速度、执行功能、持续注意力和社会认知方面的显著缺陷有关(d=-0.48 至-0.70,p<0.05)。UHR-P 在社会认知、处理速度、言语记忆和执行功能领域的表现明显差于 UHR-BD(d=-0.39 至-0.64,p<0.05)。阴性症状与 UHR-P 组的社会认知受损有关,与 UHR-BD 组的言语记忆缺陷有关。认知障碍与两组的功能障碍有关。
结论:虽然 UHR-P 与更广泛的认知障碍有关,但处理速度、执行功能、持续注意力和社会认知方面的缺陷可能是两个 UHR 组的共同特征。在早期干预服务中,认知应该被视为评估和干预的目标,不仅针对精神病高危个体,也针对双相情感障碍患者。
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