Cognitive function and treatment response trajectories in first-episode schizophrenia: evidence from a prospective cohort study.
Cognitive function and treatment response trajectories in first-episode schizophrenia: evidence from a prospective cohort study.
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DOI：
10.1136/bmjopen-2022-062570
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发表时间：
2022-11-21
期刊：
影响因子：
2.9
通讯作者：
MacCabe, James
中科院分区：
文献类型：
--
作者：
Millgate, Edward;Griffiths, Kira;Egerton, Alice;Kravariti, Eugenia;Casetta, Cecilia;Deakin, Bill;Drake, Richard;Howes, Oliver D.;Kassoumeri, Laura;Khan, Sobia;Lankshear, Steve;Lees, Jane;Lewis, Shon;Mikulskaya, Elena;Oloyede, Ebenezer;Owens, Rebecca;Pollard, Rebecca;Rich, Nathalie;Smart, Sophie;Segev, Aviv;Verena Sendt, Kyra;MacCabe, James
这项前瞻性队列研究测试了首次发病早期个体的基线认知表现与精神病抗精神病药物治疗之间的相关性。我们假设，在最初评估时认知功能较差与随后6周抗精神病药物反应较差相关。前瞻性队列。从两个英国研究中心（英国伦敦国王学院和英国曼彻斯特大学）招募的诊断为首发精神分裂症、最近开始使用抗精神病药物的国民健康服务使用者。参与者在筛选后参加了三次研究访视。共招募了89名参与者，其中46人被纳入主要分析。参与者需要在发病的前2年内，接受过最低限度的抗精神病药物治疗，有能力提供同意书，并且能够用英语阅读和书写。如果参与者符合缓解标准或表现出轻度至无症状，则将其排除在外。在第6周时使用阳性和阴性综合征量表（PANSS）确定抗精神病药应答，在每次访视时使用精神分裂症认知简明评估（BACS）评估认知表现。从轨迹分析以及从>20% PANSS标准鉴定的组（应答者和无应答者）在基线BACS表现上进行比较。轨迹分析确定84.78%的样本为治疗应答，其余15.22%为治疗无应答。未校正和校正的logistic回归分析未观察到基线BACS子量表和总表现（BACS t评分：OR=0.98，p=0.620，Cohen's d=0.218）与6周时的抗精神病药应答之间存在显著关系。本研究确定了抗精神病药物治疗前6周的两个明确的治疗反应轨迹。应答者和非应答者组在BACS上的表现没有显著差异，这表明可能需要更大的样本，或者在疾病发作的前2年内无法观察到认知表现与抗精神病药物应答之间的关联。REC：17/NI/0209。
This prospective cohort study tested for associations between baseline cognitive performance in individuals early within their first episode and antipsychotic treatment of psychosis. We hypothesised that poorer cognitive functioning at the initial assessment would be associated with poorer antipsychotic response following the subsequent 6 weeks. Prospective cohort. National Health Service users with a first-episode schizophrenia diagnosis, recently starting antipsychotic medication, recruited from two UK sites (King’s College London, UK and University of Manchester, UK). Participants attended three study visits following screening. Eighty-nine participants were recruited, with 46 included in the main analysis. Participants required to be within the first 2 years of illness onset, had received minimal antipsychotic treatment, have the capacity to provide consent, and be able to read and write in English. Participants were excluded if they met remission criteria or showed mild to no symptoms. Antipsychotic response was determined at 6 weeks using the Positive and Negative Syndrome Scale (PANSS), with cognitive performance assessed at each visit using the Brief Assessment of Cognition in Schizophrenia (BACS). The groups identified (responders and non-responders) from trajectory analyses, as well as from >20% PANSS criteria, were compared on baseline BACS performance. Trajectory analyses identified 84.78% of the sample as treatment responsive, and the remaining 15.22% as treatment non-responsive. Unadjusted and adjusted logistic regressions observed no significant relationship between baseline BACS on subscale and total performance (BACS t-score: OR=0.98, p=0.620, Cohen’s d=0.218) and antipsychotic response at 6 weeks. This investigation identified two clear trajectories of treatment response in the first 6 weeks of antipsychotic treatment. Responder and non-responder groups did not significantly differ on performance on the BACS, suggesting that larger samples may be required or that an association between cognitive performance and antipsychotic response is not observable in the first 2 years of illness onset. REC: 17/NI/0209.
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DOI：
10.1176/appi.ajp.2011.10081209
发表时间：
2011-08
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Carrión RE;Goldberg TE;McLaughlin D;Auther AM;Correll CU;Cornblatt BA
通讯作者：
Cornblatt BA
影响因子：
4.3
作者：
Hill SK;Bishop JR;Palumbo D;Sweeney JA
通讯作者：
Sweeney JA
影响因子：
17.7
作者：
Kapur, S;Zipursky, R;Houle, S
通讯作者：
Houle, S
影响因子：
4.5
作者：
ADDINGTON, J;ADDINGTON, D;MATICKATYNDALE, E
通讯作者：
MATICKATYNDALE, E
影响因子：
3.7
作者：
Abdin, Edimansyah;Chong, Siow Ann;Subramaniam, Mythily
通讯作者：
Subramaniam, Mythily