Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: A longitudinal first-episode study with 7-year follow-up
Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: A longitudinal first-episode study with 7-year follow-up
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DOI：
10.1176/appi.ajp.162.3.495
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发表时间：
2005-03-01
影响因子：
17.7
通讯作者：
Andreasen, NC
中科院分区：
文献类型：
--
作者：
Milev, P;Ho, BC;Andreasen, NC
目的：在大多数研究慢性患者且采用横断面设计的研究中，已经确定了精神分裂症患者认知与预后之间的关系。本研究的目的是在纵向设计中分析发病时评估的神经认知变量与功能预后之间的关系。另一个感兴趣的领域是阴性症状的严重程度是否会独立于神经认知变量预测预后，或者它们的预测能力是否会有重叠。
方法：作者对99名首次发病的受试者进行了全面的认知测试和临床评估，并分析了入组时的认知和症状严重程度与平均随访7年后的社区预后之间的关系。
结果：言语记忆、加工速度和注意力以及入组时阴性症状的严重程度与后续预后相关。整体心理社会功能由阴性症状和注意力预测。言语记忆是娱乐活动受损程度的重要预测因素。人际关系受损由阴性症状和记忆预测，而注意力和阴性症状可预测工作表现。认知变量和阴性症状对预后解释的方差存在重叠。
结论：言语记忆、加工速度和注意力是改善预后的心理社会干预的潜在目标。横断面研究或慢性患者研究的结果不一定与本项前瞻性首发研究的结果一致，在本研究中认知似乎对预后方差的解释较少。
Objective: The relationship between cognition and outcome in people with schizophrenia has been established in studies that, for the most part, examined chronic patients and were cross-sectional in design. The purpose of this study was to analyze the relationships between neurocognitive variables assessed at illness onset and functional outcome in a longitudinal design. An additional area of interest was whether the severity of negative symptoms would predict outcome independently from neurocognitive variables or whether there would be an overlap in their predictive power.Method: The authors administered a comprehensive cognitive battery and clinical assessments to 99 subjects who were in their first episode of illness and analyzed the relationship of cognition and symptom severity at intake with community outcome after an average follow-up period of 7 years.Results: Verbal memory, processing speed and attention, and the severity of negative symptoms at intake were related to subsequent outcome. Global psychosocial functioning was predicted by negative symptoms and attention. Verbal memory was the significant predictor of the degree of impairment in recreational activities. Impairment in relationships was predicted by negative symptoms and memory, whereas attention and negative symptoms were predictive of work performance. There was an overlap in the variance in outcome explained by cognitive variables and negative symptoms.Conclusions: Verbal memory and processing speed and attention are potential targets for psychosocial interventions to improve outcome. Results from cross-sectional or chronic patient studies do not necessarily correspond to the findings of this prospective first-episode study in which cognition appears to explain less of the variance in outcome.