The age of onset and cognitive impairment at the early stage of schizophrenia.
The age of onset and cognitive impairment at the early stage of schizophrenia.
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精神分裂症的发病年龄和早期认知障碍。
DOI：
10.1007/s11571-022-09814-1
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发表时间：
2023
影响因子：
3.7
通讯作者：
Tan,Yunlong
中科院分区：
文献类型：
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作者：
Yin,Yi;Li,Shuangshuang;Tong,Jinghui;Huang,Junchao;Tian,Baopeng;Chen,Song;Cui,Yimin;Tan,Shuping;Wang,Zhiren;Yang,Fude;Tong,Yongsheng;Hong,LElliot;Tan,Yunlong
在精神分裂症中，首次发病年龄可以反映遗传负荷并预测预后。对于早期精神分裂症患者的发病年龄和认知能力之间的关系知之甚少。我们的目的是比较早发性精神分裂症（EOS，发病年龄< 18岁）、典型发作性精神分裂症（TOS，发病年龄在18 - 39岁之间）和晚发性精神分裂症（LOS，发病年龄在40 - 59岁之间）患者治疗前的神经认知特征。我们纳入了3年内当前诊断为精神分裂症、未接受过药物治疗或累积抗精神病药物暴露少于2周且当前每日抗精神病药物剂量相当于≤ 15 mg奥氮平的个体。评估包括MATRICS共识认知成套测验（MCCB）和阳性和阴性症状量表（PANSS）。我们使用线性回归来比较发病年龄组之间的差异。我们纳入了356名参与者（67名EOS，195名TOS和94名LOS）。与LOS相比，TOS与调整受教育年限后的MCCB语言学习评分和PANSS子量表评分较低相关（45.5 ± 12.9 vs. 40.5 ± 14.1，adjusteddB = − 5.79，p = 0.001）。三组在其他认知领域得分上无差异。发病年龄与MCCB言语记忆呈U型关系（发病年龄的平方，校正dB = 0.02，p = 0.003）。与TOS患者相比，LOS患者具有更好的语言学习功能。这些结果表明，对TOS患者进行认知评估和康复训练是必要的。
In schizophrenia, the age of first episode onset can reflect genetic loading and predict prognosis. Little is known about the association between the age of onset and cognition among individuals with early-stage schizophrenia. We aimed to compare the pre-treatment neurocognition profile between individuals with early-onset schizophrenia (EOS, the age of onset < 18 years), typical-onset schizophrenia (TOS, the age of onset between 18 and 39 years), and late-onset schizophrenia (LOS, the age of onset between 40 and 59 years). We included individuals with a current diagnosis of schizophrenia within 3 years and medication naive or less than 2 weeks of cumulative antipsychotic exposure and current daily antipsychotic dosage equivalent to ≤ 15 mg of olanzapine. Assessments included the MATRICS Consensus Cognitive Battery (MCCB) and the Positive and Negative Syndrome Scale (PANSS). We used linear regression to compare the difference between age-of-onset groups. We included 356 participants (67 EOS, 195 TOS, and 94 LOS). Compared with LOS, TOS was associated with lower scores in the verbal learning scores of the MCCB after adjusting for education years and the subscale scores of the PANSS (45.5 ± 12.9 vs. 40.5 ± 14.1, adjustedB= − 5.79,p= 0.001). The three groups had no difference in other cognitive domain scores. The association between the age of onset and MCCB verbal memory was U-shape (square of the age of onset, adjustedB= 0.02,p= 0.003). Patients with LOS had a better verbal learning function compared with individuals with TOS. These findings suggest that involvement of cognition assessment and rehabilitation training is necessary for patients with TOS.