The Relationship of Neurocognition and Negative Symptoms to Social and Role Functioning Over Time in Individuals at Clinical High Risk in the First Phase of the North American Prodrome Longitudinal Study
The Relationship of Neurocognition and Negative Symptoms to Social and Role Functioning Over Time in Individuals at Clinical High Risk in the First Phase of the North American Prodrome Longitudinal Study
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DOI：
10.1093/schbul/sbt235
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发表时间：
2014-11-01
影响因子：
6.6
通讯作者：
Seidman, Larry J.
中科院分区：
文献类型：
--
作者：
Meyer, Eric C.;Carrion, Ricardo E.;Seidman, Larry J.
目的：社会、角色和神经认知功能受损是后来发展成精神病的人的病前特征。在精神分裂症患者中，神经认知和阴性症状与功能障碍有关。我们研究了随着时间的推移，神经认知和症状对临床高危(CHR)个体的社会和角色功能的相对贡献，并确定负面症状是否介导了认知对功能的影响。方法：在北美先证性纵向研究第一阶段(NAPLS-1)中对167名精神病患者进行社会、角色和神经认知功能以及阳性、阴性和紊乱症状的评估，其中96人在12个月后重新评估。结果：回归分析表明，负性症状解释了基线和随访时社会和角色功能的独特差异。复合神经认知对基线时的社会和角色功能以及随访时的角色功能的差异是独特的，但不大。负性症状在复合神经认知与社会和角色功能之间的关系中起到了中介作用。在探索性分析中，个别测试(智商估计、数字符号/编码、言语记忆)选择性地考虑了基线时的社会和角色功能，以及在考虑到症状后的随访。剔除内容与社会和角色功能测量重叠的阴性症状项后，神经认知与社会和角色功能之间的关系得到加强。结论：神经认知、阴性症状、社会和角色功能之间的适度重叠表明，这些领域对慢性阻塞性肺疾病个体有很大的独立贡献。
Objectives: Impaired social, role, and neurocognitive functioning are preillness characteristics of people who later develop psychosis. In people with schizophrenia, neurocognition and negative symptoms are associated with functional impairment. We examined the relative contributions of neurocognition and symptoms to social and role functioning over time in clinically high-risk (CHR) individuals and determined if negative symptoms mediated the influence of cognition on functioning. Methods: Social, role, and neurocognitive functioning and positive, negative, and disorganized symptoms were assessed in 167 individuals at CHR for psychosis in the North American Prodrome Longitudinal Study Phase 1 (NAPLS-1), of whom 96 were reassessed at 12 months. Results: Regression analyses indicated that negative symptoms accounted for unique variance in social and role functioning at baseline and follow-up. Composite neurocognition accounted for unique, but modest, variance in social and role functioning at baseline and in role functioning at follow-up. Negative symptoms mediated the relationship between composite neurocognition and social and role functioning across time points. In exploratory analyses, individual tests (IQ estimate, Digit Symbol/Coding, verbal memory) selectively accounted for social and role functioning at baseline and follow-up after accounting for symptoms. When negative symptom items with content overlapping with social and role functioning measures were removed, the relationship between neurocognition and social and role functioning was strengthened. Conclusion: The modest overlap among neurocognition, negative symptoms, and social and role functioning indicates that these domains make substantially separate contributions to CHR individuals.