Cognitive impairment in adolescent and adult-onset psychosis: a comparative study.

IF 3.4 3区医学 Q1 PEDIATRICS

Child and Adolescent Psychiatry and Mental Health Pub Date : 2024-09-28 DOI:10.1186/s13034-024-00815-y

TianHong Zhang, YanYan Wei, XiaoChen Tang, LiHua Xu, HuiRu Cui, YeGang Hu, HaiChun Liu, ZiXuan Wang, Tao Chen, ChunBo Li, JiJun Wang

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引用次数: 0

Abstract

Background: Cognitive impairment presents in both adolescent-onset(ado-OP) and adult-onset psychosis(adu-OP). Age and neurodevelopmental factors likely contribute to cognitive differences. This study aimed to characterize cognitive functions in ado-OP compared to adu-OP in a clinical population with drug-naive first-episode psychosis(FEP).

Methods: A total of 788 drug-naive patients with FEP and 774 sex- and age-matched healthy controls(HCs) were included. Participants were divided into four groups by whether they were under or over 21 years of age: adolescent-onset FEP(ado-FEP, n = 380), adult-onset FEP(adu-FEP, n = 408), adolescent HC(ado-HC, n = 334), and adult HC(adu-HC, n = 440). Comprehensive cognitive assessments were performed using the MATRICS Cognitive Consensus Battery(MCCB), covers six cognitive domains: speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning, and problem-solving. Data analyses were conducted using correlation analyses and binary logistic regression.

Results: The patterns of cognitive domain differences between ado-FEP and adu-FEP were found to be similar to those between ado-HC and adu-HC, whereas cognitive impairments appeared to be more pronounced in patients with adu-OP than ado-OP. The mazes subtest had the maximum effect size(ES) in the FEP(ES = 0.37) and HC(ES = 0.30) groups when comparing the adolescent and adult groups. Cognitive subtests were mostly significantly correlated with negative symptoms, especially for adolescents with FEP, in which all the subtests were significantly correlated with negative symptoms in the ado-FEP group. Better performance in the domains of spatial cognition and problem-solving abilities was more likely in the ado-FEP group than in the adu-FEP group.

Conclusions: These findings suggest cognitive differences between adolescents and adults but similar patterns of affected domains in HCs and patients with FEP. Therefore, the development of targeted cognitive interventions tailored to the specific needs of different age groups appears warranted.

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青少年和成年精神病患者的认知障碍：一项比较研究。

背景：青少年发病型精神病（ado-OP）和成人发病型精神病（adu-OP）都会出现认知障碍。年龄和神经发育因素可能是造成认知差异的原因。本研究的目的是在对药物过敏的首发精神病（FEP）临床人群中，对ado-OP与adu-OP的认知功能进行比较：研究共纳入了788名未服药的FEP患者和774名性别与年龄相匹配的健康对照组（HCs）。按照年龄是否在21岁以下或21岁以上将参与者分为四组：青少年发病型FEP（ado-FEP，n = 380）、成人发病型FEP（ado-FEP，n = 408）、青少年HC（ado-HC，n = 334）和成人HC（ado-HC，n = 440）。综合认知评估采用 MATRICS 认知共识电池（MCCB）进行，涵盖六个认知领域：处理速度、注意力/警觉性、工作记忆、言语学习、视觉学习、推理和解决问题。数据分析采用了相关分析和二元逻辑回归法：结果：发现ado-FEP和ado-FEP在认知领域的差异模式与ado-HC和ado-HC相似，而ado-OP患者的认知障碍似乎比ado-OP更明显。在青少年组和成人组的比较中，迷宫子测试在 FEP 组（ES = 0.37）和 HC 组（ES = 0.30）的效应大小（ES）最大。认知分测验大多与消极症状有显著相关性，尤其是对 FEP 青少年而言，在 ado-FEP 组中，所有分测验都与消极症状有显著相关性。在空间认知和解决问题的能力方面，ado-FEP 组比adu-FEP 组更有可能取得更好的成绩：这些研究结果表明，青少年和成人在认知能力方面存在差异，但高危人群和 FEP 患者在受影响领域的模式相似。因此，似乎有必要针对不同年龄组的具体需求制定有针对性的认知干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child and Adolescent Psychiatry and Mental Health PEDIATRICSPSYCHIATRY-PSYCHIATRY

CiteScore

7.00

自引率

3.60%

发文量

审稿时长

16 weeks

期刊介绍： Child and Adolescent Psychiatry and Mental Health, the official journal of the International Association for Child and Adolescent Psychiatry and Allied Professions, is an open access, online journal that provides an international platform for rapid and comprehensive scientific communication on child and adolescent mental health across different cultural backgrounds. CAPMH serves as a scientifically rigorous and broadly open forum for both interdisciplinary and cross-cultural exchange of research information, involving psychiatrists, paediatricians, psychologists, neuroscientists, and allied disciplines. The journal focusses on improving the knowledge base for the diagnosis, prognosis and treatment of mental health conditions in children and adolescents, and aims to integrate basic science, clinical research and the practical implementation of research findings. In addition, aspects which are still underrepresented in the traditional journals such as neurobiology and neuropsychology of psychiatric disorders in childhood and adolescence are considered.