Knížková Karolína, Keřková Barbora, Večeřová Monika, Šustová Petra, Jonáš Juraj, Siroňová Aneta, Hrubý Aleš, Rodriguez Mabel
National Institute of Mental Health, Klecany, Czech Republic.
Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
Schizophr Res Cogn. 2024 Apr 5;37:100311. doi: 10.1016/j.scog.2024.100311. eCollection 2024 Sep.
Acute and transient psychotic disorder (ATPD) is characterized by acute onset of psychotic symptoms and early recovery. Contrastingly, schizophrenia (SZ) is a chronic mental disorder characterized by impaired functioning including a deficit in cognition. In SZ, the cognitive deficit is among the core symptoms, but in ATPDs, the existing evidence brings mixed results. Our primary aim was to compare three core cognitive domains (executive functioning/abstraction, speed of processing and working memory) of patients diagnosed with ATPD and SZ over a 12-month period. Moreover, we explored how these diagnostic subgroups differed in their clinical characteristics. We recruited 39 patients with a diagnosis of SZ and 31 with ATPD with schizophrenic symptoms. All patients completed clinical and neuropsychological assessments. At baseline, we used a one-way ANCOVA model with a group as the between-subjects factor. Mixed-model repeated-measures ANOVAs with time as the within-subjects factor and group as the between-subjects factor were run to test the overtime differences. At baseline, we did not find any differences in cognition - with sex, education and age as covariates - between ATPDs and SZ. After one year, all patients showed an improvement in all three domains, however, there were no significant overtime changes between ATPDs and SZ. Regarding clinical profiles, ATPDs demonstrated less severe psychopathology and better functioning compared to SZ both at baseline and after 12 months. The medication dosage differed at retest, but not at baseline between the groups. Our findings suggest clinical differences and a similar trajectory of cognitive performance between these diagnostic subgroups.
急性短暂性精神病性障碍（ATPD）的特点是精神病性症状急性起病且恢复较早。相比之下，精神分裂症（SZ）是一种慢性精神障碍，其特征是功能受损，包括认知缺陷。在精神分裂症中，认知缺陷是核心症状之一，但在急性短暂性精神病性障碍中，现有证据得出的结果不一。我们的主要目的是比较被诊断为急性短暂性精神病性障碍和精神分裂症的患者在12个月期间的三个核心认知领域（执行功能/抽象思维、处理速度和工作记忆）。此外，我们探讨了这些诊断亚组在临床特征上的差异。我们招募了39名被诊断为精神分裂症的患者和31名有精神分裂症症状的急性短暂性精神病性障碍患者。所有患者均完成了临床和神经心理学评估。在基线时，我们使用以组为组间因素的单向协方差分析模型。采用以时间为组内因素、组为组间因素的混合模型重复测量方差分析来检验随时间的差异。在基线时，以性别、教育程度和年龄作为协变量，我们未发现急性短暂性精神病性障碍患者和精神分裂症患者在认知方面存在任何差异。一年后，所有患者在所有三个领域均有改善，然而，急性短暂性精神病性障碍患者和精神分裂症患者之间随时间没有显著变化。关于临床特征，无论是在基线时还是12个月后，急性短暂性精神病性障碍患者的精神病理学症状均不如精神分裂症患者严重，且功能更好。复测时两组的药物剂量不同，但基线时无差异。我们的研究结果表明，这些诊断亚组之间存在临床差异，且认知表现轨迹相似。
