Abbreviated neuropsychological assessment in schizophrenia: prediction of different aspects of outcome.
Abbreviated neuropsychological assessment in schizophrenia: prediction of different aspects of outcome.
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DOI：
10.1080/13803390802251386
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发表时间：
2009-05
影响因子：
2.2
通讯作者：
Bowie CR
中科院分区：
文献类型：
--
作者：
Harvey PD;Keefe RS;Patterson TL;Heaton RK;Bowie CR
本研究的目的是确定神经心理学测试的最佳子集，预测功能的几个不同方面在一个大样本（n = 236）的老年精神分裂症患者。虽然简化的评估方法的有效性已经过检验，但从来没有对认知障碍的不同因素，现实世界的结果和基于性能的功能能力测量的预测进行过比较研究。来自神经心理学评估电池的10个不同测试的分数被用来预测全球神经心理学（NP）表现（用平均分数或计算的一般缺陷分数索引），日常生活技能和社交能力的基于表现的指数，以及真实世界功能的案例管理者评级。前向逐步回归分析用于确定每个结局指标的最佳预测因子。然后，对分析进行了调整，以估计发病前的智商，这降低了相关性的大小，但没有结构。大量（超过70%）的总体NP性能的方差占有限数量的NP测试。功能能力测量的相当大的差异也是由数量有限的测试造成的。不同的测试构成了每个结果测量的最佳预测集。在几个不同的NP和功能结果的差异的很大一部分可以解释的少数NP测试，可以在几分钟内完成，虽然有相当大的无法解释的差异。然而，最能预测不同结局的简化评估在不同结局之间存在差异。未来的研究应确定是否可以通过简要评估来捕获对药理学和补救治疗的反应。
The aim of this study was to identify the best subset of neuropsychological tests for prediction of several different aspects of functioning in a large (n = 236) sample of older people with schizophrenia. While the validity of abbreviated assessment methods has been examined before, there has never been a comparative study of the prediction of different elements of cognitive impairment, real-world outcomes, and performance-based measures of functional capacity. Scores on 10 different tests from a neuropsychological assessment battery were used to predict global neuropsychological (NP) performance (indexed with averaged scores or calculated general deficit scores), performance-based indices of everyday-living skills and social competence, and case-manager ratings of real-world functioning. Forward entry stepwise regression analyses were used to identify the best predictors for each of the outcomes measures. Then, the analyses were adjusted for estimated premorbid IQ, which reduced the magnitude, but not the structure, of the correlations. Substantial amounts (over 70%) of the variance in overall NP performance were accounted for by a limited number of NP tests. Considerable variance in measures of functional capacity was also accounted for by a limited number of tests. Different tests constituted the best predictor set for each outcome measure. A substantial proportion of the variance in several different NP and functional outcomes can be accounted for by a small number of NP tests that can be completed in a few minutes, although there is considerable unexplained variance. However, the abbreviated assessments that best predict different outcomes vary across outcomes. Future studies should determine whether responses to pharmacological and remediation treatments can be captured with brief assessments as well.
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