Neuropsychological, clinical and cognitive insight predictors of outcome in a first episode psychosis study
Neuropsychological, clinical and cognitive insight predictors of outcome in a first episode psychosis study
复制标题
DOI：
10.1016/j.schres.2013.06.005
复制
发表时间：
2013-09-01
影响因子：
4.5
通讯作者：
David, Anthony S.
中科院分区：
文献类型：
--
作者：
O'Connor, Jennifer A.;Wiffen, Benjamin;David, Anthony S.
精神病首次发作（FEP）的结果是高度可变的，难以预测。我们前瞻性地研究了127例FEP患者的纵向队列中自知力差和神经心理学缺陷对结局的影响。对参与者进行了5个认知功能领域和2个洞察力领域（临床和认知）的评估。在12个月时，再次评估患者的症状严重程度和心理社会功能。回归分析显示，认知洞察力（自我反省和自我确定的措施）是最好的基线预测整体精神病理学在12个月，而执行功能的表现，在入院的研究表明，后来的严重程度的阴性症状。其他神经心理学和洞察力指标在1年时对心理社会功能的预测效果较差。结果表明，特定的神经心理和洞察力因素有单独的预测能力，表明他们是不同的心理过程中的精神病。认知洞察力被证明是一个有用的预后指标，并应考虑为未来的研究，并作为一个潜在的治疗重点。(C)2013 Elsevier B.V.保留所有权利。
The outcome of first episode psychosis (FEP) is highly variable and difficult to predict. We studied prospectively the impact of poor insight and neuropsychological deficits on outcomes in a longitudinal cohort of 127 FEP patients. Participants were assessed on 5 domains of cognitive function and 2 domains of insight (clinical and cognitive). At 12 months, patients were assessed again for symptom severity and psychosocial function. Regression analyses revealed that cognitive insight (a measure of self-reflectiveness and self-certainty) was the best baseline predictor of overall psychopathology at 12 months whereas executive function performance at admission to the study indicated later severity of negative symptoms. Other neuropsychological and insight measures were poor predictors of psychosocial function at 1 year. The results suggest that specific neuropsychological and insight factors have separate predictive capacities indicating that they are distinct psychological processes in psychosis. Cognitive insight proved to be a useful prognostic indicator, and should be considered for future studies and as a potential focus for treatment. (C) 2013 Elsevier B.V. All rights reserved.