Relationship of cognition and psychopathology to functional impairment in schizophrenia
Relationship of cognition and psychopathology to functional impairment in schizophrenia
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DOI：
10.1176/appi.ajp.2008.07111713
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发表时间：
2008-08-01
影响因子：
17.7
通讯作者：
Keefe, Richard S. E.
中科院分区：
文献类型：
--
作者：
Mohamed, Somaia;Rosenheck, Robert;Keefe, Richard S. E.
目的：本研究评估了临床抗精神病药物干预效果试验(CATIE)中神经认知和症状与社会和职业功能的相关性。1386名患者的症状用阳性和阴性症状量表(PANSS)和PANSS阴性症状量表进行测量，PANSS阴性症状量表剔除了与社区功能或神经认知测量最重叠的项目。海因里希-卡朋特生活质量量表(Heinrichs-Carpenter Quality of Life Scale)是评价者根据患者的自我报告完成的，最近的就业情况用于评估社区功能。分层回归分析和混合模型检验神经认知和症状与社会/职业功能的关系，以及这些指标在治疗过程中的变化。结果：在双因素相关分析中，症状和神经认知都与生活质量有关。与神经认知功能相比，症状对生活质量增量解释差异的贡献更大，但这两种测量都与生活质量显著相关。在一项仅包括阳性症状量表的分析中，生活质量中增加的可解释差异与神经认知相关。在横断面混合模型分析中，神经认知和两种症状测量与生活质量独立相关。治疗期间神经认知和两种症状测量的变化也与生活质量的变化显著相关。结论：精神病性症状和神经认知缺陷似乎是精神分裂症患者生活质量下降的独立原因。
Objective: This study evaluated the association of neurocognition and symptoms with measures of social and occupational functioning in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE).Method: CATIE was an 18-month study of individuals with schizophrenia. Symptoms of 1,386 patients were measured with the positive syndrome scale of the Positive and Negative Syndrome Scale (PANSS) and a PANSS negative symptom scale that eliminated items that most overlap with measures of community functioning or neurocognition. The Heinrichs-Carpenter Quality of Life Scale, which a rater completes on the basis of the patient's self-report, and recent employment were used to assess community functioning. Hierarchical regression analyses and mixed models tested the association of neurocognition and symptoms with social/occupational functioning as well as changes in these measures during treatment.Results: Both symptoms and neurocognition were associated with quality of life in bivariate correlation analyses. Symptoms contributed more to the incremental explained variance in quality of life than did neurocognitive functioning, but both kinds of measures were significantly related to quality of life. In an analysis including only the positive syndrome scale, the increased explained variance in quality of life was about equal to that associated with neurocognition. Neurocognition and both symptom measures were independently associated with quality of life in the cross-sectional mixed-model analysis. Changes in neurocognition and both symptom measures during treatment were also significantly associated with change in the quality of life.Conclusions: Both psychotic symptoms and neurocognitive deficits appear to contribute independently to decreased quality of life in schizophrenia.