Zhang TianHong, Wei YanYan, Tang XiaoChen, Xu LiHua, Cui HuiRu, Hu YeGang, Liu HaiChun, Wang ZiXuan, Chen Tao, Li ChunBo, Wang JiJun
Shanghai Mental Health Center, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders (No.13dz2260500), Shanghai Jiaotong University School of Medicine, 600 Wanping Nan Road, Shanghai, 200030, China.
Department of Automation, Shanghai Jiao Tong University, Shanghai, 200240, China.
Child Adolesc Psychiatry Ment Health. 2024 Sep 28;18(1):122. doi: 10.1186/s13034-024-00815-y.
Cognitive impairment presents in both adolescent-onset(ado-OP) and adult-onset psychosis(adu-OP). Age and neurodevelopmental factors likely contribute to cognitive differences. This study aimed to characterize cognitive functions in ado-OP compared to adu-OP in a clinical population with drug-naive first-episode psychosis(FEP).
A total of 788 drug-naive patients with FEP and 774 sex- and age-matched healthy controls(HCs) were included. Participants were divided into four groups by whether they were under or over 21 years of age: adolescent-onset FEP(ado-FEP, n = 380), adult-onset FEP(adu-FEP, n = 408), adolescent HC(ado-HC, n = 334), and adult HC(adu-HC, n = 440). Comprehensive cognitive assessments were performed using the MATRICS Cognitive Consensus Battery(MCCB), covers six cognitive domains: speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning, and problem-solving. Data analyses were conducted using correlation analyses and binary logistic regression.
The patterns of cognitive domain differences between ado-FEP and adu-FEP were found to be similar to those between ado-HC and adu-HC, whereas cognitive impairments appeared to be more pronounced in patients with adu-OP than ado-OP. The mazes subtest had the maximum effect size(ES) in the FEP(ES = 0.37) and HC(ES = 0.30) groups when comparing the adolescent and adult groups. Cognitive subtests were mostly significantly correlated with negative symptoms, especially for adolescents with FEP, in which all the subtests were significantly correlated with negative symptoms in the ado-FEP group. Better performance in the domains of spatial cognition and problem-solving abilities was more likely in the ado-FEP group than in the adu-FEP group.
These findings suggest cognitive differences between adolescents and adults but similar patterns of affected domains in HCs and patients with FEP. Therefore, the development of targeted cognitive interventions tailored to the specific needs of different age groups appears warranted.
青少年起病的精神病（ado-OP）和成人起病的精神病（adu-OP）均存在认知障碍。年龄和神经发育因素可能导致认知差异。本研究旨在描述首次发作未用药的精神病（FEP）临床人群中ado-OP与adu-OP相比的认知功能特征。
共纳入788例首次发作未用药的FEP患者和774例性别及年龄匹配的健康对照（HC）。参与者按年龄是否在21岁以下或以上分为四组：青少年起病的FEP（ado-FEP，n = 380）、成人起病的FEP（adu-FEP，n = 408）、青少年HC（ado-HC，n = 334）和成人HC（adu-HC，n = 440）。使用MATRICS认知共识电池（MCCB）进行全面的认知评估，涵盖六个认知领域：加工速度、注意力/警觉性、工作记忆、言语学习、视觉学习、推理和问题解决。使用相关分析和二元逻辑回归进行数据分析。
发现ado-FEP和adu-FEP之间的认知领域差异模式与ado-HC和adu-HC之间的相似，而adu-OP患者的认知障碍似乎比ado-OP患者更明显。在比较青少年组和成人组时，迷宫子测试在FEP组（效应量[ES]=0.37）和HC组（ES = 0.30）中具有最大效应量。认知子测试大多与阴性症状显著相关，尤其是FEP青少年，其中ado-FEP组的所有子测试均与阴性症状显著相关。ado-FEP组在空间认知和问题解决能力领域的表现比adu-FEP组更可能更好。
这些发现表明青少年和成人之间存在认知差异，但HC和FEP患者受影响领域的模式相似。因此，针对不同年龄组的特定需求制定有针对性的认知干预措施似乎是必要的。
