Neurocognition as a predictor of transition to psychotic disorder and functional outcomes in ultra-high risk participants: Findings from the NEURAPRO randomized clinical trial
Neurocognition as a predictor of transition to psychotic disorder and functional outcomes in ultra-high risk participants: Findings from the NEURAPRO randomized clinical trial
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DOI：
10.1016/j.schres.2018.12.013
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发表时间：
2019-04-01
影响因子：
4.5
通讯作者：
Allott, Kelly A.
中科院分区：
文献类型：
--
作者：
Bolt, Luke K.;Amminger, G. Paul;Allott, Kelly A.
背景资料：精神病超高风险（UHR）个体所经历的神经认知障碍是该人群结局的潜在预测因素，但涉及的特定神经认知领域存在不一致性。本研究旨在检查基线神经认知是否可预测中期向精神病的转变或功能结局（平均= 3.4年）的随访，同时控制与向精神病转变相关的其他临床/治疗变量。方法：作为omega-3脂肪酸和认知行为病例管理的多中心RCT的一部分收集的数据分析对294名参与者（134名男性，160名女性）进行了UHR个体的神经认知评估（精神分裂症认知简要评估）。使用危险精神状态综合评估（CAARMS）确定向精神病的转变，并使用整体功能：社会和角色量表测量功能。平均基线z分数表明，UHR参与者在所有领域的表现都比标准平均值低四分之一到半个标准差（范围平均z = -0.24至-0.47），执行功能除外（平均z = 0.16）。调整协变量后，较差的执行（p = 0.010）和运动（p = 0.030）功能预测过渡到精神病。处理速度和语言流畅性是显着的预测因子的角色功能在12个月（p = .004），和社会功能在中期随访（p = .015），respectively.Conclusions：神经认知能力是两个过渡到精神病和功能的结果在UHR人口的独立预测因子。需要进一步的研究来确定UHR个体的风险变量的最佳组合，以预测精神病转变，功能和其他精神病理学结果。(C)2018爱思唯尔B. V.保留所有权利。
Background: Neurocognitive impairments experienced by individuals at ultra-high risk (UHR) for psychosis are potential predictors of outcome within this population, however there is inconsistency regarding the specific neurocognitive domains implicated. This study aimed to examine whether baseline neurocognition predicted transition to psychosis, or functional outcomes, at medium-term (mean = 3.4 years) follow-up, while controlling for other clinical/treatment variables associated with transition to psychosis.Method: Analysis of data collected as part of a multi-centre RCT of omega-3 fatty acids and cognitive-behavioural case management (NEURAPRO) for UHR individuals was conducted on the 294 participants (134 males, 160 females) who completed neurocognitive assessment (Brief Assessment of Cognition for Schizophrenia) at baseline. Transition to psychosis was determined using the Comprehensive Assessment of At-Risk Mental States (CAARMS), and functioning was measured with the Global Functioning: Social and Role Scales.Results: Mean baseline z-scores indicated that UHR participants performed a quarter to half a standard deviation below normative means in all domains (range mean z = -0.24 to -0.47), except for executive functioning (mean z = 0.16). After adjusting for covariates, poorer Executive (p = .010) and Motor (p = .030) functions were predictive of transition to psychosis. Processing Speed and Verbal Fluency were significant predictors of role functioning at 12 months (p = .004), and social functioning at medium-term follow-up (p = .015), respectively.Conclusions: Neurocognitive abilities are independent predictors of both transition to psychosis and functional outcomes within the UHR population. Further research is needed to determine the best combination of risk variables in UHR individuals for prediction of psychosis transition, functioning and other psychopathology outcomes. (C) 2018 Elsevier B.V. All rights reserved.