Neuropsychological course in the prodrome and first episode of psychosis: Findings from the PRIME North America Double Blind Treatment Study
Neuropsychological course in the prodrome and first episode of psychosis: Findings from the PRIME North America Double Blind Treatment Study
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DOI：
10.1016/j.schres.2008.07.008
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发表时间：
2008-10-01
影响因子：
4.5
通讯作者：
McGlashan, Thomas H.
中科院分区：
文献类型：
--
作者：
Hawkins, Keith A.;Keefe, Richard S. E.;McGlashan, Thomas H.
目的：精神分裂症认知缺陷的发病时间存在不确定性。我们调查是否转化为精神病和/或奥氮平改变受试者的神经心理过程中首次双盲药物研究假定精神分裂症首发前驱症状。方法：在一项双盲试验中，60名参与者将奥氮平作为假定的前驱状态的治疗方法，在入组时（随机化前）进行评估，在6个月和12个月时再次进行评估（如果他们仍然是非精神病性的），或者在精神病前的任何一个点进行评估，随后进行精神病后评估和精神病后6个月的评估。结果：转化为精神病的参与者在随机化前的整体神经心理状态与安慰剂非转化者没有差异。早期皈依者与后期皈依者在进入神经心理状态上没有差异。6个月后转换的受试者在最初的精神病前6个月没有表现出神经心理衰退。在精神病转化者和非转化者之间，或者在奥氮平和安慰剂分配的受试者之间，神经心理病程没有差异。结论：对于在初始（精神病前）评估中被认为是高危人群的患者，无论是坦白性精神病的发作，还是前驱症状的奥氮平治疗，都不能显著改变其神经心理病程。这些发现表明，与精神病相关的神经心理缺陷在很大程度上早于第一次坦率的精神病发作。(c) 2008 Elsevier B.V.版权所有
Objective: There is uncertainty regarding the onset timing of the cognitive deficiencies of schizophrenia. We investigated whether conversion to psychosis and/or olanzapine altered the neuropsychological course of subjects within the first-ever double blind medication study of the putative schizophrenia first episode prodrome.Method: Sixty participants in a double blind trial of olanzapine as a treatment for putative prodromal states were assessed at entry (prerandomization), and again at 6 and 12 months (if they remained non-psychotic), or at any of these points prior to psychosis followed by post-psychosis and 6 months post-psychosis assessments.Results: Participants who converted to psychosis did not differ from placebo non-converters in pre-randomization global neuropsychological status. Early converters did not differ from later converters in entry neuropsychological status. Subjects who converted after 6 months did not show neuropsychological declines during the initial, pre-psychosis, 6 months. Neuropsychological course did not differ between converters to psychosis and non-converters, or between olanzapine and placebo-assigned subjects.Conclusions: Neither the onset of frank psychosis nor olanzapine treatment of the prodrome significantly alters neuropsychological course in persons considered to be at high risk at their initial (pre-psychosis) assessment. These findings suggest that the neuropsychological deficiencies associated with psychotic conditions largely pre-exist the first frank psychotic episode. (c) 2008 Elsevier B.V. All rights reserved.