Wang Weiyan, Peng Xingjie, Hei Gangrui, Long Yujun, Xiao Jingmei, Shao Tiannan, Li Li, Yang Ye, Wang Xiaoyi, Song Chuhan, Huang Yuyan, Cai Jingda, Huang Jing, Kang Dongyu, Wang Ying, Zhao Jingping, Tang Hui, Wu Renrong
Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, China.
Eur Arch Psychiatry Clin Neurosci. 2025 Apr;275(3):691-699. doi: 10.1007/s00406-024-01828-6. Epub 2024 May 27.
Individuals diagnosed with schizophrenia present diverse degrees and types of cognitive impairment, leading to variations in responses to antipsychotic treatments. Understanding the underlying cognitive structures is crucial for assessing this heterogeneity. Utilizing latent profile analysis (LPA) enables the delineation of latent categories of cognitive function. Integrating this approach with a dimensional perspective allows for the exploration of the relationship between cognitive function and treatment response.
This study examined 647 patients from two distinct cohorts. Utilizing LPA within the discovery cohort (n = 333) and the replication cohort (n = 314), latent subtypes were identified categorically. The stability of cognitive structures was evaluated employing Latent Transition Analysis (LTA). The relationship between cognitive function and treatment response were investigated by comparing Positive and Negative Syndrome Scale (PANSS) reduction rates across diverse cognitive subtypes. Furthermore, dimensional insights were gained through correlation analyses between cognitive tests and PANSS reduction rates.
In terms of categorical, individuals diagnosed with schizophrenia can be categorized into three distinct subtypes: those 'without cognitive deficit', those 'with mild-moderate cognitive 'eficit', and those 'with moderate-severe cognitive deficit'. There are significant differences in PANSS reduction rates among patients belonging to these subtypes following antipsychotic treatment (p < 0.05). Furthermore, from a dimensional perspective, processing speed at baseline is positively correlated with PANSS score reduction rates at week 8/week 10 (p < 0.01).
Our findings have unveiled the latent subtypes of cognitive function in schizophrenia, illuminating the association between cognitive function and responses to antipsychotic treatment from both categorical and dimensional perspectives.
被诊断为精神分裂症的个体存在不同程度和类型的认知障碍，导致对抗精神病药物治疗的反应存在差异。了解潜在的认知结构对于评估这种异质性至关重要。利用潜在剖面分析（LPA）能够描绘认知功能的潜在类别。将这种方法与维度视角相结合，可以探索认知功能与治疗反应之间的关系。
本研究考察了来自两个不同队列的647名患者。在发现队列（n = 333）和复制队列（n = 314）中使用LPA，对潜在亚型进行分类识别。采用潜在转换分析（LTA）评估认知结构的稳定性。通过比较不同认知亚型的阳性和阴性症状量表（PANSS）减分率，研究认知功能与治疗反应之间的关系。此外，通过认知测试与PANSS减分率之间的相关分析获得维度见解。
在分类方面，被诊断为精神分裂症的个体可分为三种不同的亚型：“无认知缺陷”者、“有轻度 - 中度认知缺陷”者和“有中度 - 重度认知缺陷”者。抗精神病药物治疗后，这些亚型的患者在PANSS减分率上存在显著差异（p < 0.05）。此外，从维度角度来看，基线时的处理速度与第8周/第10周的PANSS评分减分率呈正相关（p < 0.01）。
我们的研究结果揭示了精神分裂症认知功能的潜在亚型，从分类和维度两个角度阐明了认知功能与抗精神病药物治疗反应之间的关联。
