随后发展为难治性精神分裂症患者首次发作时的认知功能。

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research Pub Date : 2025-02-01 DOI:10.1016/j.schres.2025.01.017

Juan M. Aguirre , Camila Díaz Dellarossa , Daniella Barbagelata , Javiera Vásquez , Cristián Mena , Ángeles Tepper , Juan Pablo Ramírez-Mahaluf , David Aceituno , Rubén Nachar , Juan Undurraga , Alfonso González-Valderrama , Nicolas A. Crossley

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引用次数: 0

摘要

背景：对难治性精神分裂症（TRS）认知功能的研究主要集中在慢性患者身上，这使得疾病相关功能障碍与慢性或抗精神病药物影响的认知功能障碍之间的区别更加复杂。识别早期认知差异可以深入了解TRS认知表现的本质，并作为治疗耐药性的潜在标志。方法：对智利81例首发精神分裂症患者进行队列研究。如果患者符合trip标准或在任何时候服用氯氮平，则随访并将其分类为TRS。招募57名健康对照进行组间比较。认知表现使用matrix共识认知电池进行评估。结果：51例患者被分配到治疗反应组（TRESP）， 30例患者被分配到TRS组。控制年龄和性别的多变量分析显示，TRS患者在处理速度、语言流畅性、注意力/警警性和工作记忆方面的表现较差（p值）。讨论：TRS患者在首次发作时表现出较慢的处理速度，这并不完全是由症状严重程度、抗精神病药物剂量和DUP驱动的。处理速度作为一种早期缺陷出现，可以帮助及时识别处于治疗耐药轨迹的患者，并促进氯氮平等治疗的迅速实施。

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Cognitive function at first episode in patients subsequently developing treatment-resistant schizophrenia

Background

Research on cognitive functions in treatment-resistant schizophrenia (TRS) has focused on chronic patients, complicating the distinction between disease-related deficits from those influenced by chronicity or antipsychotic exposure. Identifying early cognitive differences could offer insights into the nature of TRS cognitive performance and serve as potential markers of treatment resistance.

Methods

Cohort study of 81 first-episode schizophrenia patients from Chile. Patients were followed-up and classified as TRS if they met TRRIP criteria or were prescribed clozapine at any point. 57 healthy controls were recruited for group comparisons. Cognitive performance was assessed using the MATRICS Consensus Cognitive Battery.

Results

51 patients were allocated to the treatment-responsive group (TRESP) and 30 to the TRS sample. Multivariable analyses controlling for age and sex revealed a worse TRS performance in processing speed, verbal fluency, attention/vigilance and working memory (p values <0.05). After multiple comparison corrections, only speed of processing remained significant. When accounting for symptom severity, antipsychotic dose and duration of untreated psychosis (DUP), TRS subjects still showed significantly lower processing speed (BACS, p = 0.036; TMT-A, p = 0.027), which was not significant after correcting for multiple comparisons.

Discussion

TRS patients show slower processing speed compared to TRESP already during first episode, that is not entirely driven by symptom severity, antipsychotic dose and DUP. Processing speed emerges as an early deficit that could aid in the timely identification of patients on a treatment resistance trajectory and facilitate the prompt implementation of treatments such as clozapine.

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来源期刊

Schizophrenia Research 医学-精神病学

CiteScore

7.50

自引率

8.90%

发文量

429

审稿时长

10.2 weeks

期刊介绍： As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership! Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue. The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.