Neuropsychological profiles in individuals at clinical high risk for psychosis: relationship to psychosis and intelligence.
Neuropsychological profiles in individuals at clinical high risk for psychosis: relationship to psychosis and intelligence.
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DOI：
10.1016/j.schres.2010.06.021
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发表时间：
2010-11
影响因子：
4.5
通讯作者：
McFarlane, William R.
中科院分区：
文献类型：
--
作者：
Woodberry, Kristen A.;Seidman, Larry J.;Giuliano, Anthony J.;Verdi, Mary B.;Cook, William L.;McFarlane, William R.
表征精神病临床高风险（CHR）个体的神经心理学（NP）功能可能有助于预测精神病和了解功能结果。 NP 损伤与 CHR 样本中的一般认知能力和/或后来出现的完全精神病的相关程度需要使用匹配良好的对照进行研究。我们评估了 73 名 CHR 青少年样本中 8 个认知领域的 NP 功能，其中 13 名青少年在基线评估后出现了精神病水平的症状，另外还有 34 名健康对照 (HC) 受试者。各组在年龄、性别、种族、惯用手、科目和家长成绩以及家庭收入中位数方面进行匹配，并且在 WRAT-3 阅读（病前智商的估计）上具有可比性。轮廓分析用于检查群体差异以及智商在轮廓形状中的作用。 CHR 样本显示 NP 损伤的总体程度存在显着差异，但轮廓形状只有很小且几乎显着的差异，这主要是由于嗅觉识别方面的巨大损伤。随后出现精神病水平症状的个体表现出言语智商、言语记忆和嗅觉识别方面的严重损害，其程度与首次发作样本相当。 CHR 状态可能与中度全身性认知障碍相关，其特征是嗅觉和言语记忆中某种程度的选择性障碍。那些后来出现精神病症状的人受到的损害最为严重。未来对 CHR 样本嗅觉的研究可能会增强神经发育风险机制的早期检测和规范。
Characterizing neuropsychological (NP) functioning of individuals at clinical high risk (CHR) for psychosis may be useful for prediction of psychosis and understanding functional outcome. The degree to which NP impairments are associated with general cognitive ability and/or later emergence of full psychosis in CHR samples requires study with well-matched controls. We assessed NP functioning across eight cognitive domains in a sample of 73 CHR youth, 13 of whom developed psychotic-level symptoms after baseline assessment, and 34 healthy comparison (HC) subjects. Groups were matched on age, sex, ethnicity, handedness, subject and parent grade attainment, and median family income, and were comparable on WRAT-3 Reading, an estimate of premorbid IQ. Profile analysis was used to examine group differences and the role of IQ in profile shape. The CHR sample demonstrated a significant difference in overall magnitude of NP impairment but only a small and nearly significant difference in profile shape, primarily due to a large impairment in olfactory identification. Individuals who subsequently developed psychotic-level symptoms demonstrated large impairments in verbal IQ, verbal memory and olfactory identification comparable in magnitude to first episode samples. CHR status may be associated with moderate generalized cognitive impairments marked by some degree of selective impairment in olfaction and verbal memory. Impairments were greatest in those who later developed psychotic symptoms. Future study of olfaction in CHR samples may enhance early detection and specification of neurodevelopmental mechanisms of risk.
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