Domain-specific cognitive course in schizophrenia: Group- and individual-level changes over 10 years.
Domain-specific cognitive course in schizophrenia: Group- and individual-level changes over 10 years.
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DOI：
10.1016/j.scog.2022.100263
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发表时间：
2022-12
影响因子：
2.8
通讯作者：
Ueland, Torill
中科院分区：
文献类型：
--
作者：
Flaaten, Camilla Barthel;Melle, Ingrid;Bjella, Thomas;Engen, Magnus Johan;Asbo, Gina;Wold, Kristin Fjelnseth;Widing, Line;Gardsjord, Erlend;Saether, Linn-Sofie;Oie, Merete Glenne;Lyngstad, Siv Hege;Haatveit, Beathe;Simonsen, Carmen;Ueland, Torill
精神分裂症的认知障碍有据可查，存在于多个认知领域，并且随着时间的推移相对稳定。然而，特定领域的发展课程存在高度异质性和迹象。本研究调查了首发精神分裂症 (FES) 参与者和健康对照组的 10 年认知过程，研究了八个认知领域和综合评分，观察群体和个人水平的变化。共有 75 名 FES 参与者和 91 名健康对照者在基线和随访时接受了认知评估。线性混合模型用于群体水平分析，可靠变化指数（RCI）分析用于研究个体变化。在两个时间点都探讨了临床显着损害的发生率，使用<-1.5 SD的截止值，显着认知损害定义为≥2个领域的损害。群体层面的分析发现了群体和时间以及时间对群体互动的主要影响。两组的记忆力、精神运动处理速度和语言流畅性都有所改善，而学习、心理处理速度和工作记忆则保持稳定。 FES 参与者的注意力和认知控制能力下降。个体层面的分析主要表明 FES 和对照组均稳定，但 FES 认知控制能力下降的发生率较高。基线时，68.8% 的 FES 参与者存在临床显着损伤，而随访时这一比例为 62.3%。我们主要发现 FES 的认知随着时间的推移具有长期稳定性和适度增加，以及高度的组内异质性。我们还发现基线认知表现较差的参与者有恶化的迹象。
Cognitive impairments in schizophrenia are well-documented, present across several cognitive domains and found to be relatively stable over time. However, there is a high degree of heterogeneity and indications of domain-specific developmental courses. The present study investigated the 10-year cognitive course in participants with first-episode schizophrenia (FES) and healthy controls on eight cognitive domains and a composite score, looking at group- and individual-level changes. A total of 75 FES participants and 91 healthy controls underwent cognitive assessment at baseline and follow-up. Linear mixed models were used for group-level analyses and reliable change index (RCI) analyses were used to investigate individual change. The prevalence of clinically significant impairment was explored at both time points, using a cut-off of < −1.5 SD, with significant cognitive impairment defined as impairment on ≥2 domains. Group-level analyses found main effects of group and time, and time by group interactions. Memory, psychomotor processing speed and verbal fluency improved, while learning, mental processing speed and working memory were stable in both groups. FES participants showed deteriorations in attention and cognitive control. Individual-level analyses mainly indicated stability in both FES and controls, except for a higher prevalence of decline in cognitive control in FES. At baseline, 68.8 % of FES participants had clinically significant impairment, compared to 62.3 % at follow-up. We mainly found long-term stability and modest increases in cognition over time in FES, as well as a high degree of within-group heterogeneity. We also found indications of deterioration in participants with worse cognitive performance at baseline.
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