Cognitive clusters in first-episode psychosis

被引:18
作者
Amoretti, Silvia [1 ,2 ,3 ,4 ]
Rabelo-da-Ponte, Francisco Diego [5 ]
Rosa, Adriane Ribeiro [5 ,6 ]
Mezquida, Gisela [1 ,2 ]
Sanchez-Torres, Ana M. [7 ,8 ]
Fraguas, David [2 ,9 ]
Cabrera, Bibiana [1 ,2 ]
Lobo, Antonio [2 ,10 ]
Gonzalez-Pinto, Ana [2 ,11 ]
Pina-Camacho, Laura [2 ,9 ]
Corripio, Iluminada [2 ,12 ]
Vieta, Eduard [2 ,3 ]
Torrent, Carla [2 ,3 ]
de la Serna, Elena [2 ,13 ]
Berge, Daniel [2 ,14 ,15 ]
Bioque, Miquel [1 ,2 ]
Garriga, Marina [2 ,3 ]
Serra, Maria [3 ]
Cuesta, Manuel J. [7 ,8 ]
Bernardo, Miguel [1 ,2 ]
机构
[1] Univ Barcelona, Hosp Clin Barcelona, Neurosci Inst,Schizophrenia Unit,Dept Med, Inst Invest Biomed August Pi & Sunyer IDIBAPS,Bar, Barcelona, Spain
[2] Biomed Res Networking Ctr Mental Hlth CIBERSAM, Barcelona, Spain
[3] Univ Barcelona, Inst Neurosci, Bipolar & Depress Disorders Unit, Barcelona, Catalonia, Spain
[4] Hosp Univ Vall dHebron, Vall dHebron Res Inst VHIR, Grp Psychiat Mental Hlth & Addict, Psychiat Genet Unit,Dept Psychiat, Barcelona, Spain
[5] Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, Lab Mol Psychiat, Porto Alegre, RS, Brazil
[6] Univ Fed Rio Grande do Sul UFRGS, Dept Pharmacol, Postgrad Program Psychiat & Behav Sci, Rua Ramiro Barcelos, Porto Alegre, RS, Brazil
[7] Complejo Hosp Navarra, Dept Psychiat, Pamplona, Spain
[8] Navarra Inst Hlth Res, IdiSNA, Pamplona, Spain
[9] Univ Complutense Madrid, Hosp Gen Univ Gregorio Maranon, Sch Med, Inst Invest Sanitaria Gregorio Maranon,Dept Child, Madrid, Spain
[10] Zaragoza Univ, Inst Invest Sanitaria Aragon IIS Aragon, Dept Med & Psychiat, Zaragoza, Spain
[11] Univ Basque Country, Araba Univ Hosp, Bioaraba Res Inst, Dept Psychiat,Dept Neurociences, Vitoria, Spain
[12] Univ Autonoma Barcelona UAB, Psychiat Dept, Inst Invest Biomed St Pau IIB ST PAU, Hosp Santa Creu & St Pau, Barcelona, Spain
[13] Univ Barcelona, Hosp Clin Barcelona, Clin Inst Neurosci,IDIBAPS,Dept Med, Dept Child & Adolescent Psychiat & Psychol,20175G, Barcelona, Spain
[14] Hosp del Mar Med Res Inst IMIM, Barcelona, Spain
[15] Autonomous Univ Barcelona UAB, Barcelona, Spain
基金
欧盟地平线“2020”;
关键词
First episode; Cognitive reserve; Cognition; Neuropsychology; Early intervention; 1ST EPISODE PSYCHOSIS; NEUROCOGNITIVE DEFICITS; PREMORBID ADJUSTMENT; NEGATIVE SYMPTOMS; SCHIZOPHRENIA; RESERVE; DISORDER; SCALE; HETEROGENEITY; PERFORMANCE;
D O I
10.1016/j.schres.2021.08.021
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Impairments in a broad range of cognitive domains have been consistently reported in some individuals with first-episode psychosis (FEP). Cognitive deficits can be observed during the prodromal stage. However, the course of cognitive deficits is still unclear. The aim of this study was to identify cognitive subgroups over time and to compare their sociodemographic, clinical and functional profiles. A total of 114 patients with Schizo-phrenia Spectrum Disorders were included in the present study. We assessed subjects through psychiatric scales and eight neuropsychological tests at baseline and at two-year follow-up visit. We performed the Partition Around Medoids algorithm with all cognitive variables. Furthermore, we performed a logistic regression to identify the predictors related to the different cognitive clusters at follow-up. Two distinct subgroups were found: the first cluster characterized by cognitive impairment and a second cluster had relatively intact cognition in comparison with norms. Up to 54.7% of patients with cognitive deficits at baseline tended to improve during the first two years of treatment. Patients with intact cognition at follow-up had a higher socioeconomic status, later age of onset, lower negative symptoms and a higher cognitive reserve (CR) at baseline. CR and age of onset were the baseline variables that predicted cognitive impairment. This research allows us to obtain a better under-standing of the heterogeneous profile of psychotic disorders. Identifying the characteristics of patients who will present a cognitive impairment could improve early detection and intervention. These results suggest that enhancing CR could contribute to improving the course of the illness.
引用
收藏
页码:31 / 39
页数:9
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