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Conducting clinical studies targeting cognition in psychiatry: guiding principles and design

机译：进行精神病学中靶向认知的临床研究：指导原则和设计

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摘要

Cognitive dysfunction is common in many psychiatric disorders. While it has long been described as a core feature in schizophrenia, more recent data suggest qualitatively similar impairments in patients with bipolar disorder and major depressive disorder. There is compelling evidence to suggest that cognitive impairment contributes directly to functional disability and reduced quality of like across these disorders. As current treatments focus heavily on “primary” symptoms of mood and psychosis, the standard of care typically leaves cognitive deficits unmanaged. With this in mind, the field has recently begun to consider intervening directly on this important symptom domain, with several ongoing trials in schizophrenia. Fewer studies have targeted cognition in bipolar disorder and still fewer in MDD. With progress toward considering this domain as a target for treatment comes the need for consensus guidelines and methodological recommendations on cognitive trial design. In this manuscript, we first summarize the work conducted to date in this area for schizophrenia and for bipolar disorder. We then begin to address these same issues in MDD and emphasize the need for additional work in this area.
机译：许多精神病疾病中的认知功能障碍是常见的。虽然它长期被描述为精神分裂症中的核心特征，但最近的数据表明双相情感障碍和主要抑郁症患者的定性相似。有令人信服的证据表明认知障碍直接有助于功能性残疾，并减少这些障碍的质量。由于目前的治疗重点关注情绪和精神病的“初级”症状，护理标准通常留下认知赤字非托管。考虑到这一点，该领域最近开始考虑在这种重要的症状结构域中直接进行干预，在精神分裂症中有几种正在进行的试验。较少的研究在双相障碍中有针对性的认知，并且在MDD中仍然较少。在考虑该领域，作为治疗目标，需要了解认知试验设计的协商指南和方法论建议。在这份手稿中，我们首先总结了迄今为止的精神分裂症和双相情感障碍的迄今为止进行的工作。然后，我们开始解决MDD中的相同问题，并强调该领域需要额外的工作。

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