Neurocognitive Functioning as Intermediary Phenotype and Predictor of Psychosocial Functioning Across the Psychosis Continuum: Studies in Schizophrenia and Bipolar Disorder
Neurocognitive Functioning as Intermediary Phenotype and Predictor of Psychosocial Functioning Across the Psychosis Continuum: Studies in Schizophrenia and Bipolar Disorder
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DOI：
10.4088/jcp.08m04837yel
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发表时间：
2010-06-01
影响因子：
5.3
通讯作者：
Krabbendam, Lydia
中科院分区：
文献类型：
--
作者：
Jabben, Nienke;Arts, Baer;Krabbendam, Lydia
目的：神经认知功能可能是精神分裂症和双相情感障碍遗传风险和不良预后的一个指标。在这项研究中，分析了这两种疾病在认知领域的共同和非共同特征，以确定神经认知功能在多大程度上可能代表精神分裂症谱系障碍和双相情感障碍共同的家族脆弱性和功能不良的预测因子。方法：对符合DSM-IV标准的精神分裂症谱系障碍（n=345）和双相情感障碍（n=76）患者、两组患者的一级亲属（n=331和37）以及健康对照（n=260和61）的样本进行神经认知、精神病理学和社会心理功能评估。采用多元回归模型探讨群体状态对神经认知的影响，并探讨两组认知、症状和心理社会功能之间的关系。精神分裂症谱系研究样本于2004年9月至2008年1月招募，双相情感障碍研究样本于2004年6月至2007年7月招募。结果：与双相情感障碍患者相比，精神分裂症谱系障碍患者的认知缺陷更严重、更普遍；精神分裂症谱系障碍患者的亲属存在认知改变，但双相情感障碍患者的亲属没有。神经认知功能障碍与社会心理功能之间的关联在精神分裂症谱系障碍中比在双相情感障碍中更为普遍；对于这两种疾病，相关性仅部分由症状介导。结论：认知功能障碍作为家族脆弱性标志的证据在精神分裂症中比在双相情感障碍中更强。尽管两组患者都存在多种认知缺陷，但认知缺陷的严重程度及其后果在精神分裂症和双相情感障碍之间似乎存在部分差异，这符合一种模型，即前者存在特定的神经发育障碍，而后者没有。临床精神病学杂志2010；71(6):764-774 (C)版权所有2010年医师研究生出版社，Inc。
Objective: Neurocognitive functioning may represent an indicator of genetic risk and poor outcome in both schizophrenia and bipolar disorder. In this study, shared and nonshared characteristics in the cognitive domain in both disorders were analyzed to determine to what degree neurocognitive functioning may represent a predictor of the familial vulnerability and poor functioning that schizophrenia spectrum disorders and bipolar disorder share.Method: Neurocognition, psychopathology, and psychosocial functioning were assessed in samples of patients with a schizophrenia spectrum disorder (n=345) and bipolar disorder (n=76) meeting DSM-IV criteria, first-degree relatives of both patient groups (n=331 and n=37, respectively), and healthy controls (n=260 and n=61, respectively). Multiple regression models were used to investigate the effect of group status on neurocognition and to explore associations between cognition, symptoms, and psychosocial functioning in the 2 groups. The schizophrenia spectrum study sample was recruited between September 2004 and January 2008, and the bipolar study sample was recruited between June 2004 and July 2007.Results: Cognitive deficits were more severe and more generalized in patients with a schizophrenia spectrum disorder compared to patients with bipolar disorder; cognitive alterations were present in relatives of patients with schizophrenia spectrum disorders but not in relatives of bipolar patients. The association between neurocognitive dysfunction and psychosocial functioning was more generalized in schizophrenia spectrum disorders than in bipolar disorder; for both disorders, associations were only partly mediated by symptoms.Conclusions: The evidence for cognitive dysfunction as a marker of familial vulnerability is stronger for schizophrenia than for bipolar disorder. Although the presence of multiple cognitive deficits is shared by the 2 groups, the severity of cognitive deficits and its consequences appear to partly differ between schizophrenia and bipolar disorder, which is in line with a model that implies the specific presence of a neurodevelopmental impairment in the former but not in the latter. J Clin Psychiatry 2010;71(6):764-774 (C) Copyright 2010 Physicians Postgraduate Press, Inc.