Todesco Stefanie, Chao Thomas, Gorsuch Liam, Schütz Christian
Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, Canada.
BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority (PHSA), Vancouver, BC, Canada.
Can J Psychiatry. 2025 Jan;70(1):21-31. doi: 10.1177/07067437241303407. Epub 2024 Dec 5.
This study investigated impulsivity and working memory among CD inpatients across treatment and compared to controls.
Patients (= 56, = 38.2, = 11.7, 17F) and healthy controls (= 50, = 31.9, = 10.0, 25F) completed a battery of self-report questionnaires and behavioural tasks assessing working memory and impulsivity (response inhibition, delay discounting, reflection, decision-making). Patients were assessed within 2 weeks of admission (baseline) and at 6 months (follow-up). Controls completed a single session at baseline. Patient demographics, diagnostic status, and treatment outcome (discharge with or without medical advice) were retrieved from medical records.
Group differences in demographics were probed for inclusion as covariates. At baseline, patients had greater self-reported impulsivity on the UPPS-P (negative and positive urgency) and BIS (motor and non-planning), and greater delay discounting than controls. Among patients, there was no association between treatment adherence and working memory, self-report, or behavioural impulsivity, and no change in behavioural impulsivity was observed from baseline to follow-up.
This is the first study to assess impulsivity and working memory in the context of CD treatment. Patients exhibited greater impulsivity on choice-based and various self-report measures. The absence of treatment-related changes in impulsivity and working memory outcomes suggests that conventional treatments may be neglecting to target potentially key areas of functioning. Further research is needed to examine how treatment affects impulsivity and related functions in individuals with CD, and their impact on clinical outcomes.
本研究调查了克罗恩病（CD）住院患者在治疗过程中的冲动性和工作记忆，并与对照组进行比较。
患者（n = 56，年龄 = 38.2岁，标准差 = 11.7，17名女性）和健康对照组（n = 50，年龄 = 31.9岁，标准差 = 10.0，25名女性）完成了一系列自我报告问卷和行为任务，以评估工作记忆和冲动性（反应抑制、延迟折扣、反思、决策）。患者在入院后2周内（基线）和6个月时（随访）接受评估。对照组在基线时完成一次测试。从病历中获取患者的人口统计学信息、诊断状态和治疗结果（出院时有无医嘱）。
对人口统计学的组间差异进行探测，以作为协变量纳入。在基线时，患者在UPPS-P量表（消极和积极冲动性）和BIS量表（运动和非计划性冲动性）上自我报告的冲动性更高，延迟折扣也比对照组更大。在患者中，治疗依从性与工作记忆、自我报告或行为冲动性之间没有关联，从基线到随访未观察到行为冲动性的变化。
这是第一项在CD治疗背景下评估冲动性和工作记忆的研究。患者在基于选择的和各种自我报告测量中表现出更高的冲动性。冲动性和工作记忆结果中缺乏与治疗相关的变化表明，传统治疗可能忽视了针对潜在的关键功能领域。需要进一步研究来检查治疗如何影响CD患者的冲动性和相关功能，以及它们对临床结果的影响。
