耐药性精神分裂症的形式思维障碍和神经认知。

IF 3.3 3区 医学 Q2 PSYCHIATRY
Mohammed Alarabi, Leah Burton, Valerie Powell, Tanner Isinger, Sri Mahavir Agarwal, Gary Remington
{"title":"耐药性精神分裂症的形式思维障碍和神经认知。","authors":"Mohammed Alarabi, Leah Burton, Valerie Powell, Tanner Isinger, Sri Mahavir Agarwal, Gary Remington","doi":"10.1177/07067437241293985","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Formal thought disorders (FTDs), a core feature of schizophrenia, have been subdivided into positive and negative types, and are clinically assessed by examining speech (objective) or patient introspection (subjective). Despite being associated with poorer treatment response and worse outcomes, FTDs have been understudied in patients with schizophrenia, in particular treatment-resistant schizophrenia (TRS) or schizoaffective disorder. We aimed to explore the relationship between the severity of positive and negative FTDs and neurocognition as well as social/occupational functioning in this clinical subgroup.</p><p><strong>Method: </strong>This was a retrospective chart review conducted at the Clozapine Clinic at the Centre for Addiction and Mental Health, Toronto, Canada. We reviewed charted standardized assessment of FTDs using the Thought and Language Disorder (TALD) scale, neurocognition using the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS), and functioning using the Social and Occupational Functioning Assessment Scale (SOFAS) between October 2022 and June 2023. Following the original factor structure of the TALD, we computed 4- factor scores that combined positive or negative and objective or subjective FTDs. We then explored the correlation between the scores from each TALD factor and the neurocognition and functioning scores.</p><p><strong>Results: </strong>We analysed data for 23 outpatients on clozapine. After the Bonferroni adjustment, total TALD scores, indicating overall severity of FTDs, were strongly and inversely correlated with SOFAS scores (<i>p</i> < 0.001). A strong inverse correlation was found between the objective positive TALD factor and Letter-Number Span verbal working memory scores, <i>r</i>(21) = -0.63, <i>p</i> < 0.001.</p><p><strong>Conclusions: </strong>Our results demonstrate the strong relationship between FTDs, neurocognition, and social/occupational functioning in a sample of TRS outpatients. Within the cognitive domains assessed, verbal working memory impairment had the strongest correlation with positive FTDs, such as derailment or tangentiality. These findings highlight the value of employing standardized psychopathological scales for FTDs in clinical practice.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Formal Thought Disorders and Neurocognition in Treatment-Resistant Schizophrenia: Trouble du cours de la pensée et neurocognition dans la schizophrénie réfractaire.\",\"authors\":\"Mohammed Alarabi, Leah Burton, Valerie Powell, Tanner Isinger, Sri Mahavir Agarwal, Gary Remington\",\"doi\":\"10.1177/07067437241293985\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Formal thought disorders (FTDs), a core feature of schizophrenia, have been subdivided into positive and negative types, and are clinically assessed by examining speech (objective) or patient introspection (subjective). Despite being associated with poorer treatment response and worse outcomes, FTDs have been understudied in patients with schizophrenia, in particular treatment-resistant schizophrenia (TRS) or schizoaffective disorder. We aimed to explore the relationship between the severity of positive and negative FTDs and neurocognition as well as social/occupational functioning in this clinical subgroup.</p><p><strong>Method: </strong>This was a retrospective chart review conducted at the Clozapine Clinic at the Centre for Addiction and Mental Health, Toronto, Canada. We reviewed charted standardized assessment of FTDs using the Thought and Language Disorder (TALD) scale, neurocognition using the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS), and functioning using the Social and Occupational Functioning Assessment Scale (SOFAS) between October 2022 and June 2023. Following the original factor structure of the TALD, we computed 4- factor scores that combined positive or negative and objective or subjective FTDs. We then explored the correlation between the scores from each TALD factor and the neurocognition and functioning scores.</p><p><strong>Results: </strong>We analysed data for 23 outpatients on clozapine. After the Bonferroni adjustment, total TALD scores, indicating overall severity of FTDs, were strongly and inversely correlated with SOFAS scores (<i>p</i> < 0.001). A strong inverse correlation was found between the objective positive TALD factor and Letter-Number Span verbal working memory scores, <i>r</i>(21) = -0.63, <i>p</i> < 0.001.</p><p><strong>Conclusions: </strong>Our results demonstrate the strong relationship between FTDs, neurocognition, and social/occupational functioning in a sample of TRS outpatients. Within the cognitive domains assessed, verbal working memory impairment had the strongest correlation with positive FTDs, such as derailment or tangentiality. These findings highlight the value of employing standardized psychopathological scales for FTDs in clinical practice.</p>\",\"PeriodicalId\":55283,\"journal\":{\"name\":\"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2024-11-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/07067437241293985\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/07067437241293985","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0

摘要

客观性:形式思维障碍(FTDs)是精神分裂症的一个核心特征,可细分为阳性和阴性两种类型,临床上通过检查言语(客观)或患者内省(主观)来评估。尽管FTD与较差的治疗反应和较差的预后有关,但对精神分裂症患者,尤其是耐药精神分裂症(TRS)或分裂情感障碍患者的FTD研究一直不足。我们的目的是探讨这一临床亚群中阳性和阴性FTD的严重程度与神经认知以及社会/职业功能之间的关系:这是一项在加拿大多伦多成瘾与精神健康中心氯氮平诊所进行的回顾性病历审查。我们回顾了2022年10月至2023年6月期间使用思维和语言障碍量表(TALD)对FTD进行的标准化评估、使用精神分裂症简明认知评估工具(B-CATS)对神经认知进行的评估,以及使用社会和职业功能评估量表(SOFAS)对功能进行的评估。根据 TALD 的原始因子结构,我们计算出了 4 个因子分数,将积极或消极、客观或主观的 FTD 结合在一起。然后,我们探讨了 TALD 各因子得分与神经认知和功能得分之间的相关性:我们分析了 23 名使用氯氮平的门诊患者的数据。经过Bonferroni调整后,表示FTD整体严重程度的TALD总分与SOFAS得分呈强烈的反相关(p r(21) = -0.63, p 结论:我们的研究结果表明,FTD与SOFAS之间存在密切的关系:我们的研究结果表明,在TRS门诊患者样本中,FTD、神经认知和社会/职业功能之间存在密切关系。在所评估的认知领域中,言语工作记忆障碍与出轨或切题等正向 FTDs 的相关性最强。这些发现凸显了在临床实践中采用标准化精神病理学量表来评估 FTD 的价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Formal Thought Disorders and Neurocognition in Treatment-Resistant Schizophrenia: Trouble du cours de la pensée et neurocognition dans la schizophrénie réfractaire.

Objective: Formal thought disorders (FTDs), a core feature of schizophrenia, have been subdivided into positive and negative types, and are clinically assessed by examining speech (objective) or patient introspection (subjective). Despite being associated with poorer treatment response and worse outcomes, FTDs have been understudied in patients with schizophrenia, in particular treatment-resistant schizophrenia (TRS) or schizoaffective disorder. We aimed to explore the relationship between the severity of positive and negative FTDs and neurocognition as well as social/occupational functioning in this clinical subgroup.

Method: This was a retrospective chart review conducted at the Clozapine Clinic at the Centre for Addiction and Mental Health, Toronto, Canada. We reviewed charted standardized assessment of FTDs using the Thought and Language Disorder (TALD) scale, neurocognition using the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS), and functioning using the Social and Occupational Functioning Assessment Scale (SOFAS) between October 2022 and June 2023. Following the original factor structure of the TALD, we computed 4- factor scores that combined positive or negative and objective or subjective FTDs. We then explored the correlation between the scores from each TALD factor and the neurocognition and functioning scores.

Results: We analysed data for 23 outpatients on clozapine. After the Bonferroni adjustment, total TALD scores, indicating overall severity of FTDs, were strongly and inversely correlated with SOFAS scores (p < 0.001). A strong inverse correlation was found between the objective positive TALD factor and Letter-Number Span verbal working memory scores, r(21) = -0.63, p < 0.001.

Conclusions: Our results demonstrate the strong relationship between FTDs, neurocognition, and social/occupational functioning in a sample of TRS outpatients. Within the cognitive domains assessed, verbal working memory impairment had the strongest correlation with positive FTDs, such as derailment or tangentiality. These findings highlight the value of employing standardized psychopathological scales for FTDs in clinical practice.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信