Espinosa Victoria, Bagaeva Alana, López-Carrilero Raquel, Barajas Ana, Barrigón María Luisa, Birulés Irene, Frígola-Capell Eva, Díaz-Cutraro Luciana, González-Higueras Fermín, Grasa Eva, Gutiérrez-Zotes Alfonso, Lorente-Rovira Ester, Pélaez Trinidad, Pousa Esther, Ruiz-Delgado Isabel, Verdaguer-Rodríguez Marina, Ochoa Susana
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.
Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
Eur Arch Psychiatry Clin Neurosci. 2025 Apr;275(3):701-713. doi: 10.1007/s00406-024-01813-z. Epub 2024 May 28.
An increasing interest in the assessment of neuropsychological performance variability in people with first-episode psychosis (FEP) has emerged. However, its association with clinical and functional outcomes requires further study. Furthermore, FEP neuropsychological subgroups have not been characterized by clinical insight or metacognition and social cognition domains. The aim of this exploratory study was to identify specific groups of patients with FEP based on neuropsychological variables and to compare their sociodemographic, clinical, metacognition and social cognition profiles. A sample of 149 FEP was recruited from adult mental health services. Neuropsychological performance was assessed by a neuropsychological battery (WAIS-III; TMT; WSCT; Stroop Test; TAVEC). The assessment also included sociodemographic characteristics, clinical, functional, metacognition and social cognition variables. Two distinct neuropsychological profiles emerged: one neuropsychological impaired cluster (N = 56) and one relatively intact cluster (N = 93). Significant differences were found between both profiles in terms of sociodemographic characteristics (age and level of education) (p = 0.001), clinical symptoms (negative, positive, disorganized, excitement and anxiety) (p = 0.041-0.001), clinical insight (p = 0.038-0.017), global functioning (p = 0.014), as well as in social cognition domains (emotional processing and theory of mind) (p = 0.001; p = 0.002). No significant differences were found in metacognitive variables (cognitive insight and 'jumping to conclusions' bias). Relationship between neurocognitive impairment, social cognition and metacognition deficits are discussed. Early identifying of neuropsychological profiles in FEP, characterized by significant differences in clinical and social cognition variables, could provide insight into the prognosis and guide the implementation of tailored early-intervention.
人们对首发精神病(FEP)患者神经心理表现变异性的评估兴趣日益浓厚。然而,其与临床和功能结局的关联仍需进一步研究。此外,FEP神经心理亚组尚未通过临床洞察力、元认知和社会认知领域进行特征描述。本探索性研究的目的是根据神经心理变量识别FEP患者的特定群体,并比较他们的社会人口统计学、临床、元认知和社会认知概况。从成人心理健康服务机构招募了149名FEP患者样本。通过神经心理测验组合(韦氏成人智力量表第三版;连线测验;威斯康星卡片分类测验;斯特鲁普测验;语言流畅性测验)评估神经心理表现。评估还包括社会人口统计学特征、临床、功能、元认知和社会认知变量。出现了两种不同的神经心理概况:一个神经心理受损组(N = 56)和一个相对完整组(N = 93)。在社会人口统计学特征(年龄和教育水平)(p = 0.001)、临床症状(阴性、阳性、紊乱、兴奋和焦虑)(p = 0.041 - 0.001)、临床洞察力(p = 0.038 - 0.017)、整体功能(p = 0.014)以及社会认知领域(情绪加工和心理理论)(p = 0.001;p = 0.002)方面,两组之间存在显著差异。在元认知变量(认知洞察力和“急于下结论”偏差)方面未发现显著差异。讨论了神经认知障碍、社会认知和元认知缺陷之间的关系。早期识别FEP患者的神经心理概况,其特点是临床和社会认知变量存在显著差异,这可能有助于了解预后并指导实施针对性的早期干预。