Neuropsychological impairments in schizophrenia and psychotic bipolar disorder: findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study.
Neuropsychological impairments in schizophrenia and psychotic bipolar disorder: findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study.
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DOI：
10.1176/appi.ajp.2013.12101298
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发表时间：
2013-11
期刊：
影响因子：
--
通讯作者：
Sweeney JA
中科院分区：
文献类型：
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作者：
Hill SK;Reilly JL;Keefe RS;Gold JM;Bishop JR;Gershon ES;Tamminga CA;Pearlson GD;Keshavan MS;Sweeney JA
家族性神经心理学缺陷在精神分裂症中已得到很好的证实，但在其他精神病性障碍中仍缺乏很好的特征。本研究来自中间表型双极-精神分裂症网络（B-SNIP）联盟1）比较精神分裂症和双相情感障碍与精神病的认知障碍，2）测试精神病性障碍中认知功能障碍的连续模型，3）报告精神病性障碍中认知障碍的家族性，4）评估具有和不具有A群人格特征的非精神病性亲属的认知障碍。参与者包括先证者精神分裂症（N=293），精神病性双相情感障碍（N=227），情感障碍（躁狂，N=110;抑郁，N=55），他们的一级亲属（N=316，N=259，N=133，N=64，分别），和健康对照组（N=295）。所有参与者都完成了精神分裂症（BACS）神经心理学成套测验。与健康对照组相比，精神病先证者的认知障碍从双相情感障碍（z=-0.77）到情感障碍（躁狂z=-1.08;抑郁z=-1.25）再到精神分裂症（z=-1.42）逐渐加重。BACS各子测试的特征在各种疾病中相似。缺陷的家族性在精神分裂症和双相情感障碍中具有显著性和可比性。特别令人感兴趣的是，在先证者诊断中，具有升高的A群人格特征的亲属的神经心理缺陷水平相似。没有这些人格特征的精神分裂症先证者的非精神病亲属表现出明显的认知障碍，而双相先证者的亲属则没有。精神分裂症和精神病性双相情感障碍存在家族性认知缺陷。跨精神病性障碍的认知障碍的严重程度是一致的连续模型，其中更突出的情感特征和持久的精神病与较少的认知障碍。与精神分裂症相比，精神病性双相情感障碍患者一级亲属的认知功能障碍与精神病谱系人格障碍特征的关系更为密切。
Familial neuropsychological deficits are well established in schizophrenia but remain less well characterized in other psychotic disorders. This study from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium 1) compares cognitive impairment in schizophrenia and bipolar disorder with psychosis, 2) tests a continuum model of cognitive dysfunction in psychotic disorders, 3) reports familiality of cognitive impairments across psychotic disorders, and 4) evaluates cognitive impairment among nonpsychotic relatives with and without cluster A personality traits. Participants included probands with schizophrenia (N=293), psychotic bipolar disorder (N=227), schizoaffective disorder (manic, N=110; depressed, N=55), their first-degree relatives (N=316, N=259, N=133, and N=64, respectively), and healthy comparison subjects (N=295). All participants completed the Brief Assessment of Cognition in Schizophrenia (BACS) neuropsychological battery. Cognitive impairments among psychotic probands, compared to healthy comparison subjects, were progressively greater from bipolar disorder (z=−0.77) to schizoaffective disorder (manic z=−1.08; depressed z=−1.25) to schizophrenia (z=−1.42). Profiles across subtests of the BACS were similar across disorders. Familiality of deficits was significant and comparable in schizophrenia and bipolar disorder. Of particular interest were similar levels of neuropsychological deficits in relatives with elevated cluster A personality traits across proband diagnoses. Nonpsychotic relatives of schizophrenia probands without these personality traits exhibited significant cognitive impairments, while relatives of bipolar probands did not. Robust cognitive deficits are present and familial in schizophrenia and psychotic bipolar disorder. Severity of cognitive impairments across psychotic disorders was consistent with a continuum model, in which more prominent affective features and less enduring psychosis were associated with less cognitive impairment. Cognitive dysfunction in first-degree relatives is more closely related to psychosis-spectrum personality disorder traits in psychotic bipolar disorder than in schizophrenia.