Factors mediating cognitive deficits and psychopathology among siblings of individuals with schizophrenia
Factors mediating cognitive deficits and psychopathology among siblings of individuals with schizophrenia
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DOI：
10.1093/schbul/sbj082
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发表时间：
2006-07-01
影响因子：
6.6
通讯作者：
Csernansky, John G.
中科院分区：
文献类型：
--
作者：
Delawalla, Zainab;Barch, Deanna M.;Csernansky, John G.
分裂型特征和认知障碍已知存在于精神分裂症患者的一级亲属中。然而，人们对这些内表型之间的关系知之甚少。我们在精神分裂症患者、他们的兄弟姐妹、社区对照组和他们的兄弟姐妹中探索了这种关系的本质。所有参与者都在工作记忆、注意力、情景记忆和执行功能以及他们的积极、消极和混乱症状的水平上进行了评估。与其他3组相比，精神分裂症先证者在所有认知领域均显著受损，并表现出最高水平的阳性、阴性和紊乱症状。先证者兄弟姐妹在工作记忆、情景记忆和执行功能任务上的表现明显差于对照组，并且与对照组相比，他们表现出明显更多的阳性和阴性症状。在所有4个认知领域中，较差的任务表现与负面症状的增加最为密切相关。中介分析显示，工作记忆、情景记忆和执行功能缺陷部分介导了先证者兄弟姐妹中阴性症状的增加。负性症状完全介导工作记忆和情景记忆缺陷，但仅部分介导执行功能缺陷。结果表明，在这一高危人群中，认知和临床因素之间存在复杂的关系。
Schizotypal traits and cognitive disturbances are known to be present in first-degree relatives of people with schizophrenia. However, there is little understanding of how these endophenotypes are related to each other. We explored the nature of this relationship in individuals with schizophrenia, their full siblings, community controls, and their siblings. All participants were assessed in the domains of working memory, attention, episodic memory, and executive function, as well as in their level of positive, negative, and disorganization symptoms. Schizophrenia probands were significantly impaired on all cognitive domains, as compared with the other 3 groups, and displayed the highest levels of positive, negative, and disorganization symptoms. Proband siblings performed significantly worse than controls on tasks of working memory, episodic memory, and executive function, and they displayed significantly more positive and negative symptoms as compared with controls. Poorer task performance across all 4 cognitive domains was most strongly correlated with increased negative symptoms. Mediation analyses revealed that working memory, episodic memory, and executive function deficits partially mediated increases in negative symptoms among proband siblings. Negative symptoms fully mediated deficits in working memory and episodic memory but only partially mediated deficits in executive function. Results suggest that there is a complex relationship between cognitive and clinical factors in this high-risk population.