Ryan Sai Ting Chu, Ivan Wai Lok Chu, Esther Wing-Chi Yip, Joe Kwun Nam Chan, Corine Sau Man Wong, Christy Lai-Ming Hui, Eric Yu Hai Chen, Sherry Kit Wa Chan, Edwin Ho Ming Lee, Simon Sai Yu Lui, Wing Chung Chang
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Subgroup analyses and meta-regression examining the moderating effect of sex, age at PE assessment, study design, cognitive task, and PE assessment instrument on cognitive functioning were performed when applicable. The study was registered with PROSPERO (CRD42023442528). Twenty-seven and six studies were included for meta-analysis of cognitive functioning comparing individuals with versus without PEs (n = 82,561; 10,251 individuals with PEs) and individuals with high-level versus low-level PEs (n = 8062; 813 individuals with high-level PEs), respectively. Individuals with PEs exhibited worse cognitive performance in general cognition (Hedges'g = -0.10 [95%CI = -0.18 to -0.02]), verbal fluency (Hedges'g = -0.05 [95%CI = -0.10 to -0.00]), visual memory (Hedges'g = -0.21 [95%CI = -0.38 to -0.03]), and working memory (Hedges'g = -0.16 [95%CI = -0.28 to -0.04]). Meta-regression revealed that general cognition associated with PEs was related to younger age (z = 3.37, p = 0.001), male sex (z = -2.59, p = 0.010), and cognitive assessment before PE assessment (z = -2.15, p = 0.031), whereas working memory in individuals with PEs was associated with concurrent cognitive and PE assessment (z = 6.19, p < 0.001). We failed to find moderating effect of the choice of PE assessment instrument or cognitive task on cognitive functioning in PEs. Additional analysis showed no significant difference in the performance of any cognitive domains between individuals with high-level versus low-level PEs. Limitations included studies primarily derived from Western countries, no social-cognitive domains, and varied PE measurement. In sum, PEs are associated with milder and more circumscribed cognitive impairment relative to psychotic disorders. 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引用次数: 0
摘要
早期的研究表明,精神病经历(PEs)这种扩展性精神病表型与认知障碍有关。然而,最近的研究显示,研究结果较为混杂,PEs 中认知障碍的模式和程度仍不确定。我们的目的是系统地回顾和定量地综合对患有与未患有 PEs 的个体认知功能的评估,这些评估涵盖了广泛的领域。我们系统地检索了从开始到 2023 年 7 月 6 日的四个数据库。我们使用随机效应模型生成了集合效应大小(Hedges'g)。在适当的情况下,我们还进行了分组分析和元回归,以检验性别、PE 评估时的年龄、研究设计、认知任务和 PE 评估工具对认知功能的调节作用。该研究已在 PROSPERO 注册(CRD42023442528)。在认知功能的荟萃分析中,分别纳入了 27 项和 6 项研究,比较了有 PE 与无 PE(n = 82,561; 10,251 名有 PE 的患者)和有高水平 PE 与低水平 PE(n = 8062; 813 名有高水平 PE 的患者)的患者。PEs患者在一般认知(Hedges'g = -0.10 [95%CI = -0.18 to -0.02])、语言流畅性(Hedges'g = -0.05 [95%CI = -0.10 to -0.00])、视觉记忆(Hedges'g = -0.21 [95%CI = -0.38 to -0.03])和工作记忆(Hedges'g = -0.16 [95%CI = -0.28 to -0.04])方面的认知表现较差。元回归显示,与 PE 相关的一般认知与年龄(z = 3.37,p = 0.001)、男性(z = -2.59,p = 0.010)和 PE 评估前的认知评估(z = -2.15,p = 0.031)有关,而 PE 患者的工作记忆则与同时进行的认知和 PE 评估有关(z = 6.19,p = 0.031)。
Cognitive functioning in people with psychotic experiences: a systematic review and meta-analysis study.
Earlier research suggested that psychotic experiences (PEs), the extended-psychosis phenotype, are associated with cognitive impairment. Recent studies, however, revealed more mixed findings, and patterns and magnitude of cognitive deficits in PEs remain uncertain. We aimed to systematically review and quantitatively synthesize estimates of cognitive functioning covering a wide array of domains in individuals with versus without PEs. We systematically searched four databases from inception to 6 July 2023. We generated pooled effect size (Hedges'g) using random-effects models. Subgroup analyses and meta-regression examining the moderating effect of sex, age at PE assessment, study design, cognitive task, and PE assessment instrument on cognitive functioning were performed when applicable. The study was registered with PROSPERO (CRD42023442528). Twenty-seven and six studies were included for meta-analysis of cognitive functioning comparing individuals with versus without PEs (n = 82,561; 10,251 individuals with PEs) and individuals with high-level versus low-level PEs (n = 8062; 813 individuals with high-level PEs), respectively. Individuals with PEs exhibited worse cognitive performance in general cognition (Hedges'g = -0.10 [95%CI = -0.18 to -0.02]), verbal fluency (Hedges'g = -0.05 [95%CI = -0.10 to -0.00]), visual memory (Hedges'g = -0.21 [95%CI = -0.38 to -0.03]), and working memory (Hedges'g = -0.16 [95%CI = -0.28 to -0.04]). Meta-regression revealed that general cognition associated with PEs was related to younger age (z = 3.37, p = 0.001), male sex (z = -2.59, p = 0.010), and cognitive assessment before PE assessment (z = -2.15, p = 0.031), whereas working memory in individuals with PEs was associated with concurrent cognitive and PE assessment (z = 6.19, p < 0.001). We failed to find moderating effect of the choice of PE assessment instrument or cognitive task on cognitive functioning in PEs. Additional analysis showed no significant difference in the performance of any cognitive domains between individuals with high-level versus low-level PEs. Limitations included studies primarily derived from Western countries, no social-cognitive domains, and varied PE measurement. In sum, PEs are associated with milder and more circumscribed cognitive impairment relative to psychotic disorders. Future research is required to clarify differential cognitive trajectories between individuals with transient PEs and persistent/recurrent-PEs.
期刊介绍:
Molecular Psychiatry focuses on publishing research that aims to uncover the biological mechanisms behind psychiatric disorders and their treatment. The journal emphasizes studies that bridge pre-clinical and clinical research, covering cellular, molecular, integrative, clinical, imaging, and psychopharmacology levels.