Longitudinal study of cognitive function in first-episode and recent-onset schizophrenia.
Longitudinal study of cognitive function in first-episode and recent-onset schizophrenia.
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DOI：
10.1176/ajp.156.9.1342
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发表时间：
1999-09
期刊：
影响因子：
--
通讯作者：
S. Gold;Stephan Arndt;P. Nopoulos;D. O'Leary;N. Andreasen
中科院分区：
文献类型：
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作者：
S. Gold;Stephan Arndt;P. Nopoulos;D. O'Leary;N. Andreasen
目的精神分裂症患者的认知功能是恶化、改善还是保持稳定是一个关键问题。很少有研究在一组接受良好治疗的精神分裂症患者中检查认知功能的纵向稳定性以及认知表现与临床症状之间的关系。方法在本研究中，54例首次发作和近期发作的精神分裂症患者完成了一个全面的认知测试电池，并在指数住院和5年后再次对症状措施进行了评估。结果操作智商和全面智商显著提高，而言语智商没有变化。在一些神经心理学测试中，小组的表现有所改善，包括A圈字母取消任务、逻辑记忆自由回忆测试分数和威斯康星州卡片分类测试。手指敲击的平均表现随着时间的推移而恶化，而其他神经心理学测试的表现没有变化。在此期间，阴性、精神病性和紊乱症状显著改善。阴性症状的变化与言语智商和全面智商的表现变化相关，但与表现智商无关。当阴性症状改善时，观察到言语认知改善。精神病和紊乱的症状维度与任何智商测量都不相关。结论：这些结果表明，在一组在疾病早期接受抗精神病药物治疗的年轻患者中，认知能力不会恶化，而且可能会改善。三个症状维度中只有一个--阴性--与认知表现的变化相关。这项研究支持了阴性症状与长期认知结果不良相关的观点，并可能与精神分裂症的原发性认知缺陷密切相关。
OBJECTIVE Whether cognitive function in schizophrenia deteriorates, improves, or remains stable is a crucial question. Few studies have examined the longitudinal stability of cognitive function and the relationship between cognitive performance and clinical symptoms over time in a cohort of well-treated patients with schizophrenia. METHOD In the present study, 54 patients with first-episode and recent-onset schizophrenia completed a comprehensive cognitive test battery and were rated on symptom measures at index hospitalization and again after 5 years. RESULTS Performance IQ and full-scale IQ significantly improved, whereas verbal IQ did not change. Group performance improved on some of the neuropsychological tests, including the Circle A letter-cancellation task, free recall of logical memory test score, and the Wisconsin Card Sorting Test. Mean finger-tapping performance worsened over time, whereas performance on other neuropsychological tests did not change. Negative, psychotic, and disorganized symptoms significantly improved over the time period. Changes in negative symptoms were correlated with performance changes in verbal IQ and full-scale IQ but not performance IQ. Improvement in verbal cognition was observed when negative symptoms improved. Psychotic and disorganized symptom dimensions were not correlated with any IQ measure. CONCLUSIONS These results indicate that in a cohort of young patients receiving neuroleptic treatment early in their illness, cognitive performance does not deteriorate--and may improve. Only one of the three symptom dimensions--negative--was associated with change in cognitive performance. This study supports the view that negative symptoms are associated with a poor long-term cognitive outcome and may be closely related to the primary cognitive deficit in schizophrenia.