精神分裂症患者的耐药性与认知功能之间的关系。

Singapore medical journal Pub Date : 2024-10-01 Epub Date: 2024-10-04 DOI:10.4103/singaporemedj.SMJ-2024-143
Jiaqian Sun, Jie Yin Yee, Yuen Mei See, Charmaine Tang, Shushan Zheng, Boon Tat Ng, Jimmy Lee
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引用次数: 0

摘要

导言:耐药精神分裂症(TRS)患者约占精神分裂症患者的 30%。在接受氯氮平治疗的TRS患者中,约有一半患者没有表现出有意义的临床反应,即氯氮平耐药。迄今为止,认知功能与治疗反应类别之间的关系尚不完全清楚。本研究评估了按治疗反应分层的亚组的认知表现,我们假设认知障碍会随着治疗耐药性的增加而增加:本研究在新加坡精神卫生研究所进行,研究对象包括健康对照组和精神分裂症患者,他们被分为以下几组:抗精神病药反应型精神分裂症(ARS)、氯氮平反应型TRS(TRS-CR)和氯氮平耐药型TRS(超耐药精神分裂症[UTRS])。认知功能采用认知简短评估短表进行评估。症状采用阳性与阴性综合征量表(PANSS)进行测量。计划进行的统计分析包括对年龄、性别、PANSS评分和抗精神病药物剂量等可能影响认知功能的协变量进行调整:结果:两组患者的整体认知能力存在明显差异:ARS受损程度最小,其次是TRS-CR和UTRS。抗精神病药物剂量、PANSS阴性和混乱/认知因素是所有患者组整体认知功能的重要预测因素:我们的研究发现,认知功能的差异与治疗耐受程度有关:治疗耐受程度越高,认知功能越差。对精神分裂症患者的认知功能和治疗效果进行干预,可能会有效改善患者的阴性症状和精神紊乱症状。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association between treatment resistance and cognitive function in schizophrenia.

Introduction: Treatment-resistant schizophrenia (TRS) affects around 30% of individuals with schizophrenia. About half of the patients with TRS who are treated with clozapine do not show a meaningful clinical response, that is, clozapine resistance. To date, the relationship between cognitive function and treatment response categories is not entirely clear. This study evaluated the cognitive performance across subgroups stratified by treatment response, and we hypothesised that cognitive impairment increases with increased treatment resistance.

Methods: This study was conducted at the Institute of Mental Health, Singapore, and included healthy controls and people with schizophrenia categorised into these groups: antipsychotic-responsive schizophrenia (ARS), clozapine-responsive TRS (TRS-CR) and clozapine-resistant TRS (ultra-treatment-resistant schizophrenia [UTRS]). Cognitive function was assessed using the Brief Assessment of Cognition-Short Form. Symptoms were measured with the Positive and Negative Syndrome Scale (PANSS). The planned statistical analyses included adjustments for covariates such as age, sex, PANSS scores and antipsychotic dose, which might affect cognitive function.

Results: There were significant differences in overall cognitive performance between the groups: ARS had the least impairment, followed by TRS-CR and UTRS. Antipsychotic dose, and PANSS negative and disorganisation/cognitive factors were significant predictors of overall cognitive function in all patient groups.

Conclusions: Our study found differences in cognitive function that aligned with levels of treatment resistance: the greater the degree of treatment resistance, the poorer the cognitive function. Interventions to improve negative and disorganisation symptoms might be effective to enhance the cognitive function and treatment outcomes in schizophrenia.

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