Longitudinal assessment of premorbid cognitive functioning in patients with schizophrenia through examination of standardized scholastic test performance
Longitudinal assessment of premorbid cognitive functioning in patients with schizophrenia through examination of standardized scholastic test performance
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DOI：
10.1176/appi.ajp.159.7.1183
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发表时间：
2002-07-01
影响因子：
17.7
通讯作者：
Andreasen, NC
中科院分区：
文献类型：
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作者：
Fuller, R;Nopoulos, P;Andreasen, NC
Objective.研究表明，精神分裂症患者存在病前认知障碍，但这些缺陷的发病和病程仍不清楚。本研究的目的是探讨纵向课程的精神分裂症患者发病前的认知功能，通过使用前瞻性的数据从学校的测试results.Method：从4年级，8年级和11年级的爱荷华州测试的基本技能和爱荷华州测试的教育发展，获得了70名受试者谁后来发展为精神分裂症。平均百分位数排名的主题的得分在词汇，阅读理解，语言，数学，信息来源，和整体复合类别进行了比较与国家normal.Results：主题得分低于第50百分位数的每个类别在所有三个等级，但只有语言，阅读，信息来源，和综合成绩从11年级显着低于国家规范。关于纵向课程，随着时间的推移，语言成绩呈显著线性下降。从11年级的分数与WAIS-R智商，语言流畅性，雷伊听觉语言学习分数在第一次发病呈正相关。从11年级的分数没有显着相关的发病年龄或评级的紊乱，精神病，或negative symptoms.Conclusions：学业考试成绩在4年级和8年级的平均水平在这组儿童谁后来发展为精神分裂症无显着低于。然而，考试成绩在8年级和11年级之间大幅下降。这相当于13-16岁，或青春期的开始。学习成绩差或下降可能是第一次发病时出现认知障碍的前兆。
Objective. Studies suggest the presence of premorbid cognitive impairment in patients with schizophrenia, yet the onset and course of these deficits remain unclear. The purpose of this study was to investigate the longitudinal course of premorbid cognitive functioning in individuals with schizophrenia by using prospective data obtained from scholastic test results.Method: Scores from grades 4, 8, and 11 on the Iowa Tests of Basic Skills and the Iowa Tests of Educational Development were obtained for 70 subjects who later developed schizophrenia. The mean percentile rank of the subjects' scores in the areas of vocabulary, reading comprehension, language, mathematics, sources of information, and an overall composite category were compared with state norms.Results: The subjects scored below the 50th percentile for each category in all three grades, but only language, reading, sources of information, and composite scores from grade 11 were significantly below state norms. With regard to longitudinal course, there was a significant linear decrease in language scores over time. Scores from grade 11 were positively correlated with WAIS-R IQ, verbal fluency, and Rey Auditory Verbal Learning scores at first illness episode. Scores from grade 11 were not significantly correlated with age at illness onset or ratings of disorganized, psychotic, or negative symptoms.Conclusions: Scholastic test scores at grades 4 and 8 were nonsignificantly below average in this group of children who later developed schizophrenia. However, test scores dropped significantly between grades 8 and 11. This corresponds to ages 13-16 years, or the onset of puberty. Poor or declining scholastic performance may be a precursor to the cognitive impairment seen during the first episode of illness.