Toward a Model of Cognitive Insight in First-Episode Psychosis: Verbal Memory and Hippocampal Structure
Toward a Model of Cognitive Insight in First-Episode Psychosis: Verbal Memory and Hippocampal Structure
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DOI：
10.1093/schbul/sbp015
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发表时间：
2010-09-01
影响因子：
6.6
通讯作者：
Lepage, M.
中科院分区：
文献类型：
--
作者：
Buchy, L.;Czechowska, Y.;Lepage, M.
我们以前的工作已经将语言学习和记忆与认知洞察力联系起来，但不是临床洞察力，在患有首发精神病（FEP）的个体中。本研究重新评估了认知和临床洞察力的神经认知基础，并探讨了61例FEP患者的神经基础。认知自知力采用Beck认知自知力量表（BCIS），临床自知力采用精神障碍无意识评定量表（SUMD）。研究了7个认知领域的全球测量。海马被手动分割成3个部分：身体、头部和尾部。言语学习记忆与BCIS综合指数显著相关。综合指数评分与左海马（HC）总体积显著相关;然而，偏相关性显示，这种关系主要归因于文字记忆表现。BCIS自我确定性分量表与双侧HC体积显著负相关，并且这些关联独立于言语学习和记忆表现。BCIS自我反省分量表与言语学习和记忆显著相关，但与HC量无关。SUMD和非文字记忆或HC体积之间没有显着的相关性。这些结果加强了我们以前的断言，在个人与FEP认知洞察力可能依赖于记忆，目前的经验是根据以前的评估。HC可能是脑系统的一个可行位置，该脑系统是FEP患者认知洞察力的基础。
Our previous work has linked verbal learning and memory with cognitive insight, but not clinical insight, in individuals with a first-episode psychosis (FEP). The current study reassessed the neurocognitive basis of cognitive and clinical insight and explored their neural basis in 61 FEP patients. Cognitive insight was measured with the Beck Cognitive Insight Scale (BCIS) and clinical insight with the Scale to assess Unawareness of Mental Disorder (SUMD). Global measures for 7 domains of cognition were examined. Hippocampi were manually segmented in to 3 parts: the body, head, and tail. Verbal learning and memory significantly correlated with the BCIS composite index. Composite index scores were significantly associated with total left hippocampal (HC) volume; partial correlations, however, revealed that this relationship was attributable largely to verbal memory performance. The BCIS self-certainty subscale significantly and inversely correlated with bilateral HC volumes, and these associations were independent of verbal learning and memory performance. The BCIS self-reflectiveness subscale significantly correlated with verbal learning and memory but not with HC volume. No significant correlations emerged between the SUMD and verbal memory or HC volume. These results strengthen our previous assertion that in individuals with an FEP cognitive insight may rely on memory whereby current experiences are appraised based on previous ones. The HC may be a viable location among others for the brain system that underlies aspects of cognitive insight in individuals with an FEP.