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首页> 外文期刊>Journal of affective disorders >Neurocognitive and clinical predictors of functional outcome in patients with schizophrenia and bipolar I disorder at one-year follow-up.
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Neurocognitive and clinical predictors of functional outcome in patients with schizophrenia and bipolar I disorder at one-year follow-up.

机译：在一年的随访中，精神分裂症和双相情感障碍患者的功能预后的神经认知和临床预测指标。

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OBJECTIVE: Many studies have reported that cognitive ability may be predictive of the functional outcome for patients with schizophrenia. However, no study has prospectively examined these aspects in schizophrenia and bipolar disorders simultaneously. The present study attempted to analyze if neurocognition and clinical status predicts the real-life functioning for patients with schizophrenia or bipolar I disorder, using a longitudinal design. METHOD: Forty-seven schizophrenic and 43 bipolar I outpatients were assessed twice with a neurocognitive battery (Executive Functions, Working Memory, Verbal Memory, Visual Memory, Visual-Motor Processing, Vigilance, Vocabulary and Motor Speed tasks), clinical scales (the Positive and Negative Symptom Scale, the Hamilton Rating Scale for Depression and the Clinician Administered Rating Scale for Mania) and functional outcome measures (the Global Assessment of Functioning Scale, the WHO's Disability Assessment Scale and occupational adaptation level) over a one-year follow-up period. The cognitive performance of the patients was compared, at baseline and one year later, with that of 25 healthy subjects. RESULTS: In schizophrenia patients, global functioning one year later was predicted by a composite neurocognitive score and three specific domain (verbal memory, motor speed, vocabulary). Symptoms appeared to explain less of the variance in functioning. In bipolar I patients, changes in the composite neurocognitive score over one year, deficits in the visual/motor processing domain, severity of symptoms (psychotic, excitatory and affective symptoms) and premorbid adjustment at the first assessment were the variables that better predicted functioning or disability changes over follow-up period. CONCLUSIONS: Although the relationships between cognition, symptoms and functional capacity differ for schizophrenia or bipolar I patients, neuropsychological performance seems to be a principal longitudinal predictor of functioning in both disorders. Baseline neurocognition and cognitive changes over 12 months predicted changes in functioning over the same period, but only in bipolar I patients. These cognitive domains could be potential neurocognitive endophenotypes (endophenocognitypes) with regard to bipolar I disorder.
机译：目的：许多研究报告说，认知能力可以预测精神分裂症患者的功能预后。然而，尚无研究前瞻性地同时检查精神分裂症和双相情感障碍的这些方面。本研究试图通过纵向设计来分析神经认知和临床状况是否能预测精神分裂症或双相性I型精神障碍患者的现实生活功能。方法：对47名精神分裂症患者和43名双相I门诊患者进行两次神经认知电池评估（执行功能，工作记忆，言语记忆，视觉记忆，视觉运动处理，警惕，词汇和运动速度任务），临床量表（阳性和负面症状量表，汉密尔顿抑郁量表和临床医生管理的躁狂量表和功能结局指标（功能性功能全球评估量表，世卫组织的残疾评估量表和职业适应水平），为期一年的随访期。在基线和一年后，将患者的认知能力与25名健康受试者的认知能力进行了比较。结果：在精神分裂症患者中，一年后的整体功能可通过复合神经认知评分和三个特定领域（语言记忆，运动速度，词汇）来预测。症状似乎不能解释功能的差异。在I型双相情感障碍患者中，一年后的复合神经认知评分变化，视觉/运动加工领域的缺陷，症状的严重程度（精神病，兴奋性和情感症状）以及病情初调时，这些变量可以更好地预测功能或随诊期间的残障变化。结论：尽管对于精神分裂症或双相I型患者，认知，症状和功能能力之间的关系不同，但神经心理学表现似乎是这两种疾病功能的主要纵向预测指标。基线神经认知和认知变化超过12个月可预测同一时期的功能变化，但仅在双相I患者中。这些认知领域可能是双相性I型障碍的潜在神经认知内表型（内表型）。

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