Relationship of neurocognitive deficits to diagnosis and symptoms across affective and non-affective psychoses.
Relationship of neurocognitive deficits to diagnosis and symptoms across affective and non-affective psychoses.
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DOI：
10.1016/j.schres.2011.09.004
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发表时间：
2011-12
影响因子：
4.5
通讯作者：
Oenguer, Dost
中科院分区：
文献类型：
--
作者：
Lewandowski, Kathryn E.;Cohen, Bruce M.;Keshavan, Matcheri S.;Oenguer, Dost
神经认知功能障碍被认为是精神分裂症的核心特征，并且越来越被认为是双相情感障碍的常见症状维度。尽管在这些疾病中有大量关于神经认知的文献，但神经认知、症状和诊断之间的关系仍不清楚。我们在精神病患者的交叉诊断样本中检查了神经认知功能。基于先前的研究结果，假设所有三组患者的神经认知功能都会受损，并且这三组患者在所有神经心理学测量中都会出现类似的受损。此外，我们预测阴性症状与神经认知功能有关，而阳性、一般或情绪症状与神经认知功能无关。对精神分裂症（n=25）、分裂情感性障碍（n=29）、双相情感障碍伴精神病（n=31）和健康对照（n=20）患者的神经认知功能和症状进行了评估。所有患者组的神经认知功能都明显受损，在大多数测量中，各组的诊断没有差异。一系列线性回归显示，阴性症状（但没有其他临床症状）预示着各组执行功能较差。诊断并不是任何神经认知变量的显著预测因子。神经认知缺陷在这个精神病患者的交叉诊断样本中是明显的，并且没有因诊断而不同。神经认知功能障碍可能代表了跨越诊断类别的症状维度，并可能反映了共同的致病过程。由于神经认知功能障碍是患者预后的最强预测因素之一，治疗这些在精神分裂症中显示出希望的缺陷的努力应该扩展到所有精神病患者。
Neurocognitive dysfunction is believed to be a core feature of schizophrenia and is increasingly recognized as a common symptom dimension in bipolar disorder. Despite a copious literature on neurocognition in these disorders, the relationship amongst neurocognition, symptoms, and diagnosis remains unclear. We examined neurocognitive functioning in a cross-diagnostic sample of patients with psychotic disorders. Based on previous findings, it was hypothesized that neurocognitive functioning would be impaired in all three patient groups, and that groups would be similarly impaired on all neuropsychological measures. Additionally, we predicted that negative symptoms but not positive, general, or mood symptoms, would be associated with neurocognitive functioning. Neurocognitive functioning and symptoms were assessed in participants with schizophrenia (n=25), schizoaffective disorder (n=29), or bipolar disorder with psychosis (n=31), and in healthy controls (n=20). Neurocognitive functioning was significantly impaired in all patient groups, and groups did not differ by diagnosis on most measures. A series of linear regressions revealed that negative symptoms (but no other clinical symptom) predicted poorer executive functioning across groups. Diagnosis was not a significant predictor of any neurocognitive variable. Neurocognitive deficits were pronounced in this cross-diagnostic sample of patients with psychotic disorders, and did not differ by diagnosis. Neurocognitive dysfunction may represent a symptom dimension that spans diagnostic categories, and may reflect shared pathogenic processes. As neurocognitive dysfunction is among the strongest predictors of outcome in patients, efforts to treat these deficits, which have shown promise in schizophrenia, should be extended to all patients with psychosis.
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