Lu Chenghao, Li Shaobing, Liu Nannan, Li Tongxin, Li Yanzhe, Wang Xinxu, Li Shen, Li Jie, Zhang Xiang Yang
Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China; Brain Assessment & Intervention Laboratory, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China; Brain Assessment & Intervention Laboratory, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
Prog Neuropsychopharmacol Biol Psychiatry. 2025 Jan 10;136:111202. doi: 10.1016/j.pnpbp.2024.111202. Epub 2024 Nov 22.
The relationship between the duration of untreated psychosis (DUP) and cognitive function in schizophrenia (SZ) patients remains debated, with no empirical evidence from event-related potential (ERP) studies supporting their association. This study aims to investigate the relationship between DUP and cognitive functions, as well as psychiatric symptoms, in first-episode antipsychotic-naïve SZ (FEAN-SZ) patients using ERP.
The study included 321 Chinese FEAN-SZ patients and 146 healthy controls. The DUP and sociodemographic characteristics of all participants were collected, and psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale. The P300 (P3) components, including P3a, P3b and N100, were recorded from all participants using auditory oddball paradigm.
25.5 % of patients did not receive timely treatment for over four years, and those with lower educational levels or more severe negative symptoms had longer DUP (p = 0.027, p = 0.020). Compared to healthy controls, FEAN-SZ patients exhibited longer latencies and lower amplitudes in the P3 components (all p < 0.001). Significant differences in the P3 components were observed among three groups of DUP (< 8 months, 8 to 48 months, and ≥ 48 months) (all p < 0.001). In the 8 ≤ DUP < 48 months group, the N1 amplitude and P3a latency predicted positive symptom scores and general psychopathology scores, respectively (β = -0.165, p = 0.037; β = 0.541, p < 0.001); P3b latency predicted negative symptom scores in the DUP < 8 months group (β = 0.391, p < 0.001). N1 amplitude predicted general psychopathology scores only in the DUP > 48 months group (β = -0.228, p = 0.040). Multiple linear regression analysis indicated that the latency and amplitude of P3a were independently associated with DUP (B = 0.124, p < 0.001; B = -1.161, p = 0.012).
SZ patients who have a longer DUP exhibit more severe P3 deficits, and the P3 components may be indicative of different psychiatric symptom severity in DUPs of different lengths, as well as the P3a component may serve as an electrophysiologic marker to assess the length of DUP.
精神分裂症（SZ）患者未治疗精神病持续时间（DUP）与认知功能之间的关系仍存在争议，事件相关电位（ERP）研究尚无实证证据支持二者存在关联。本研究旨在采用ERP研究首发未使用过抗精神病药物的SZ患者（FEAN - SZ）中DUP与认知功能以及精神症状之间的关系。
本研究纳入321例中国FEAN - SZ患者和146名健康对照者。收集所有参与者的DUP及社会人口学特征，采用阳性和阴性症状量表评估精神症状。使用听觉oddball范式记录所有参与者的P300（P3）成分，包括P3a、P3b和N100。
25.5%的患者四年多未得到及时治疗，教育水平较低或阴性症状较重的患者DUP更长（p = 0.027，p = 0.020）。与健康对照者相比，FEAN - SZ患者的P3成分潜伏期更长、波幅更低（均p < 0.001）。在DUP的三组（< 8个月、8至48个月、≥ 48个月）中观察到P3成分存在显著差异（均p < 0.001）。在8≤DUP < 48个月组中，N1波幅和P3a潜伏期分别预测阳性症状评分和总体精神病理学评分（β = -0.165，p = 0.037；β = 0.541，p < 0.001）；P3b潜伏期在DUP < 8个月组中预测阴性症状评分（β = 0.391，p < 0.001）。N1波幅仅在DUP > 48个月组中预测总体精神病理学评分（β = -0.228，p = 0.040）。多元线性回归分析表明，P3a的潜伏期和波幅与DUP独立相关（B = 0.124，p < 0.001；B = -1.161，p = 0.012）。
DUP较长的SZ患者表现出更严重的P3缺陷，P3成分可能指示不同长度DUP下不同的精神症状严重程度，并且P3a成分可能作为评估DUP长度的电生理标志物。
