Longitudinal Cognitive Performance in Individuals at Ultrahigh Risk for Psychosis: A 10-year Follow-up
Longitudinal Cognitive Performance in Individuals at Ultrahigh Risk for Psychosis: A 10-year Follow-up
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DOI：
10.1093/schbul/sby143
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发表时间：
2019-09-01
影响因子：
6.6
通讯作者：
Lin, Ashleigh
中科院分区：
文献类型：
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作者：
Allott, Kelly;Wood, Stephen J.;Lin, Ashleigh
目前尚不清楚精神病的发生是否与认知能力的恶化有关。这项研究的目的是检查超高风险(UHR)队列中认知表现的过程，以及认知变化是否与向精神病的转变和功能变化有关。1994年5月至2000年7月连续入院的个人评估和危机评估(PACE)诊所，在基线和随访时完成综合认知评估的患者符合条件(N=80)。随访期7.3~13.4年(男10.4年，SD=1.5)。在整个样本中，在相似性(P=.03)、信息(P<；.01)、数字符号编码(P<；.01)和连线测验B(P=.01)任务上显著提高，而在Rey听觉词汇学习测验(试验1-3)上的成绩显著下降(P<；.01)。在认知测量上的表现变化与过渡状态没有明显的关联。考虑到转换的时间，在1年后转换的人在数字符号编码上表现出显著的下降，而没有转换的人在这一测量上有所改善(P=.01；效应大小[ES]=0.85)。在功能改善和数字符号编码和算术方面的性能改善之间观察到较小的正相关(分别为0.24，P=0.03和0.28，P=0.01)。总而言之，精神病的发生与认知能力的恶化无关。然而，具体的发现表明，即刻言语学习和记忆以及加工速度可能是未来UHR个体风险模型和早期干预研究的相关领域。
It remains unclear whether the onset of psychosis is associated with deterioration in cognitive performance. The aim of this study was to examine the course of cognitive performance in an ultrahigh risk (UHR) cohort, and whether change in cognition is associated with transition to psychosis and change in functioning. Consecutive admissions to Personal Assessment and Crisis Evaluation (PACE) Clinic between May 1994 and July 2000 who had completed a comprehensive cognitive assessment at baseline and follow-up were eligible (N = 80). Follow-up ranged from 7.3 to 13.4 years (M = 10.4 years; SD = 1.5). In the whole sample, significant improvements were observed on the Similarities (P = .03), Information (P < .01), Digit Symbol Coding (P < .01), and Trail Making Test B (P = .01) tasks, whereas performance on the Rey Auditory Verbal Learning Test (Trials 1-3) declined significantly (P < .01) over the follow up period. Change in performance on cognitive measures was not significantly associated with transition status. Taking time to transition into account, those who transitioned after 1 year showed significant decline on Digit Symbol Coding, whereas those who did not transition improved on this measure (P = .01; effect size [ES] = 0.85). Small positive correlations were observed between improvements in functioning and improvements in performance on Digit Symbol Coding and Arithmetic (0.24, P = .03 and 0.28, P = .01, respectively). In summary, the onset of psychosis was not associated with deterioration in cognitive ability. However, specific findings suggest that immediate verbal learning and memory, and processing speed may be relevant domains for future risk models and early intervention research in UHR individuals.