认知灵活性预测首发精神病患者的阴性症状严重程度:一项为期1年的随访研究。

Cognitive Inflexibility Predicts Negative Symptoms Severity in Patients with First-Episode Psychosis: A 1-Year Follow-Up Study.

作者信息

Mantonakis Leonidas, Stefanatou Pentagiotissa, Tsionis Antonis, Konstantakopoulos George, Xenaki Lida-Alkisti, Ntigrintaki Angeliki-Aikaterini, Ralli Irene, Dimitrakopoulos Stefanos, Kollias Konstantinos, Stefanis Nikos C

机构信息

First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece.

Research Department of Clinical, Education and Health Psychology, University College London, London WC1E 7HB, UK.

出版信息

Brain Sci. 2024 Feb 5;14(2):162. doi: 10.3390/brainsci14020162.

Abstract

Negative symptoms and cognitive deficits play a major role in psychosis and significantly influence the functional outcomes of patients, particularly those with a first episode of psychosis (FEP). However, limited research has explored the predictive capacity of cognitive deficits during FEP for subsequent negative symptomatology. Drawing from the Athens FEP research study, we conducted a retrospective longitudinal study in 80 individuals with FEP. All patients were drug naive at admission. Cognitive tests were administered at 1-month and 1-year post-admission, while negative symptomatology was assessed at the same time points using PANSS by trained raters. We considered confounding factors such as age, gender, duration of untreated psychosis (DUP), treatment received, premorbid social adjustment, and premorbid IQ. Univariate regression analysis identified cognitive domains that correlated with negative symptomatology. These, along with the confounders, were incorporated into a multiple regression, with the 1-year PANSS negative scale serving as the dependent variable. Employing the backward elimination technique, we found a statistically significant inverse relationship between the categories completed in the Wisconsin card sorting test (WCST) and the 1-year PANNS negative scale ( = 0.01), beyond the associations with DUP and the 1-month PANSS negative scale. Our results suggest that cognitive flexibility, a key component of executive functions, predicts negative symptom severity one year after FEP.

摘要

阴性症状和认知缺陷在精神病中起主要作用,并显著影响患者的功能结局,尤其是首次发作精神病(FEP)的患者。然而,有限的研究探索了FEP期间认知缺陷对后续阴性症状的预测能力。基于雅典FEP研究,我们对80例FEP患者进行了一项回顾性纵向研究。所有患者入院时均未接受过药物治疗。在入院后1个月和1年进行认知测试,同时由经过培训的评估者使用阳性和阴性症状量表(PANSS)在相同时间点评估阴性症状。我们考虑了年龄、性别、未治疗精神病持续时间(DUP)、接受的治疗、病前社会适应和病前智商等混杂因素。单因素回归分析确定了与阴性症状相关的认知领域。这些因素以及混杂因素被纳入多元回归,以1年PANSS阴性量表作为因变量。采用向后排除技术,我们发现威斯康星卡片分类测试(WCST)中完成的类别与1年PANNS阴性量表之间存在统计学上显著的负相关(P = 0.01),这超出了与DUP和1个月PANSS阴性量表的关联。我们的结果表明,认知灵活性作为执行功能 的一个关键组成部分,可预测FEP一年后的阴性症状严重程度。

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