Effects of Anticholinergic Burden on Verbal Memory Performance in First-Episode Psychosis.

IF 3.3 3区 医学 Q2 PSYCHIATRY
Agnès Belkacem, Katie M Lavigne, Carolina Makowski, Mallar Chakravarty, Ridha Joober, Ashok Malla, Jai Shah, Martin Lepage
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引用次数: 0

Abstract

Objectives: Antipsychotics are widely used to treat first-episode psychosis but may have an anticholinergic burden, that is, a cumulative effect of medications that block the cholinergic system. Studies suggest that a high anticholinergic burden negatively affects memory in psychosis, where cognitive deficits, particularly those in verbal memory, are a core feature of the disease. The present study sought to replicate this in a large cohort of well-characterized first-episode psychosis patients. We expected that patients in the highest anticholinergic burden group would exhibit the poorest verbal memory compared to those with low anticholinergic burden and healthy controls at baseline (3 months following admission). We further hypothesized that over time, at month 12, patients' verbal memory performance would improve but would remain inferior to controls.

Methods: Patients (n  =  311; low anticholinergic burden [n  =  241] and high anticholinergic burden [n  =  70], defined by a Drug Burden Index cut-off of 1) and healthy controls (n  =  128) completed a clinical and neurocognitive battery including parts of the Wechsler Memory Scale at months 3 and 12.

Results: Cross-sectionally, using an analysis of variance, patients in the highest anticholinergic burden group had the poorest performance in verbal memory when compared to the other groups at month 3, F(2,430)  =  52.33, P < 0.001. Longitudinally, using a Generalized Estimating Equation model, the verbal memory performance of all groups improved over time. However, patients' performance overall remained poorer than the controls.

Conclusion: These findings highlight the importance of considering the anticholinergic burden when prescribing medications in the early stages of the disease.

抗胆碱能负荷对首发精神病言语记忆表现的影响。
目的:抗精神病药物广泛用于治疗首发精神病,但可能具有抗胆碱能负担,即阻断胆碱能系统的药物累积效应。研究表明,高抗胆碱能负荷对精神病患者的记忆产生负面影响,其中认知缺陷,特别是言语记忆缺陷是该疾病的核心特征。本研究试图在一大批特征明确的首发精神病患者中复制这一结果。我们预期在基线时(入院后3个月),与抗胆碱能负荷低组和健康对照组相比,抗胆碱能负荷最高组的患者表现出最差的言语记忆。我们进一步假设,随着时间的推移,在第12个月,患者的言语记忆表现会有所改善,但仍不如对照组。方法:患者311例;低抗胆碱能负担[n = 241]和高抗胆碱能负担[n = 70](以药物负担指数截止值为1定义),健康对照(n = 128)在第3个月和第12个月完成临床和神经认知测试,包括韦氏记忆量表的部分内容。结果:横断面方差分析显示,与其他组相比,抗胆碱能负担最重组患者在第3个月的言语记忆表现最差,F(2,430) = 52.33, P。结论:这些发现强调了在疾病早期开处方时考虑抗胆碱能负担的重要性。
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
CiteScore
7.00
自引率
2.50%
发文量
69
审稿时长
6-12 weeks
期刊介绍: Established in 1956, The Canadian Journal of Psychiatry (The CJP) has been keeping psychiatrists up-to-date on the latest research for nearly 60 years. The CJP provides a forum for psychiatry and mental health professionals to share their findings with researchers and clinicians. The CJP includes peer-reviewed scientific articles analyzing ongoing developments in Canadian and international psychiatry.
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