Change in neuropsychological functioning over one year in youth at clinical high risk for psychosis.
Change in neuropsychological functioning over one year in youth at clinical high risk for psychosis.
复制标题
临床精神病高危青少年一年内神经心理功能的变化。
DOI：
10.1016/j.schres.2013.01.017
复制
发表时间：
2013
影响因子：
4.5
通讯作者：
Seidman,LarryJ
中科院分区：
文献类型：
--
作者：
Woodberry,KristenA;McFarlane,WilliamR;Giuliano,AnthonyJ;Verdi,MaryB;Cook,WilliamL;Faraone,StephenV;Seidman,LarryJ
精神分裂症和相关的精神障碍与显著的神经心理学（NP）损伤相关。然而，这些损害的发病和发展演变仍然不完全的特点。本研究探讨了NP功能超过一年的样本中的青年在临床高风险（ESTA）的精神病参与治疗研究。我们在两个时间点评估了53名老年人和32名健康对照（HC）受试者的六个认知领域的功能。HC一年评分的线性回归用于预测基线评分和相关人口统计学变量的一年表现。我们使用原始分数和标准化残差的MANOVA来测试随时间推移的进行性损害。一年后的NP功能显著低于预测水平。执行功能测试的规范性改善失败的影响是最大的，最一致的。在基线评估后，在前驱综合征结构化访谈中达到最高阳性症状评分（6，严重和精神病性）的患者（n=10/53）表现出特别大的差异（d=-1.89），尽管不显著，但观察到的和预测的一年言语记忆测试表现之间的差异。研究结果表明，虽然许多与精神病相关的认知功能障碍是目前的精神病综合征的充分表达之前，一些进行性NP障碍可能伴随着精神病的风险，并为那些谁开发的精神病水平的症状是最大的。
Schizophrenia and related psychotic disorders are associated with significant neuropsychological (NP) impairments. Yet the onset and developmental evolution of these impairments remains incompletely characterized. This study examined NP functioning over one year in a sample of youth at clinical high risk (CHR) for psychosis participating in a treatment study. We assessed functioning across six cognitive domains at two time points in a sample of 53 CHR and 32 healthy comparison (HC) subjects. Linear regression of HC one-year scores was used to predict one-year performance for CHR from baseline scores and relevant demographic variables. We used raw scores and MANOVAs of the standardized residuals to test for progressive impairment over time. NP functioning of CHR at one year fell significantly below predicted levels. Effects were largest and most consistent for a failure of normative improvement on tests of executive function. CHR who reached the highest positive symptom rating (6, severe and psychotic) on the Structured Interview of Prodromal Syndromes after the baseline assessment (n=10/53) demonstrated a particularly large (d=−1.89), although non-significant, discrepancy between observed and predicted one-year verbal memory test performance. Findings suggest that, although much of the cognitive impairment associated with psychosis is present prior to the full expression of the psychotic syndrome, some progressive NP impairments may accompany risk for psychosis and be greatest for those who develop psychotic level symptoms.