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首页> 外文期刊>Journal of the International Neuropsychological Society: JINS >Evolving Notions of Schizophrenia as a Developmental Neurocognitive Disorder
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Evolving Notions of Schizophrenia as a Developmental Neurocognitive Disorder

机译：作为发展神经认知疾病的精神分裂症的概念

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We review the changing conceptions of schizophrenia over the past 50 years as it became understood as a disorder of brain function and structure in which neurocognitive dysfunction was identified at different illness phases. The centrality of neurocognition has been recognized, especially because neurocognitive deficits are strongly related to social and role functioning in the illness, and as a result neurocognitive measures are used routinely in clinical assessment of individuals with schizophrenia. From the original definitions of the syndrome of schizophrenia in the early 20th century, impaired cognition, especially attention, was considered to be important. Neurocognitive impairments are found in the vast majority of individuals with schizophrenia, and they vary from mild, relatively restricted deficits, to dementia-like syndromes, as early as the first psychotic episode. Neurocognitive deficits are found in the premorbid phase in a substantial minority of pre-teenage youth who later develop schizophrenia, and they apparently worsen by the prodromal, high-risk phase in a majority of those who develop the illness. While there is limited evidence for reversibility of impairments from pharmacological interventions in schizophrenia, promising results have emerged from cognitive remediation studies. Thus, we expect cognitive interventions to play a larger role in schizophrenia in the coming years. Moreover, because youth at risk for schizophrenia can be identified by an emergent high-risk syndrome, earlier interventions might be applied in a pre-emptive way to reduce disability and improve adaptation. The notion of schizophrenia as a developmental neurocognitive disorder with stages opens up a window of possibilities for earlier interventions. (JINS, 2017, 23, 881–892)
机译：我们在过去的50年中审查了精神分裂症的变化概念，因为它被理解为脑功能和结构的疾病，其中在不同疾病阶段鉴定了神经认知功能障碍的疾病。神经模型的中心性已经认识到，特别是因为神经认知缺陷与疾病中的社会和作用强烈有关，因此由于精神分裂症的个体临床评估，因此神经认知措施是神经造成的措施。从20世纪初的精神分裂症综合征的原始定义，认知受损，特别是关注，被认为是重要的。在绝大多数具有精神分裂症的绝大多数个体中发现神经认知障碍，他们从温和，相对限制的缺陷中变化到痴呆症状综合征，早期为第一集。在后来发展精神分裂症的少数青少年前青少年的主要少数青少年青年中发现了神经认知缺陷，并且在大多数发展疾病的人中，它们显然是由前批发的高风险阶段恶化。虽然精神分裂症药理干预的障碍障碍的证据有限，但有希望的结果来自认知修复研究。因此，我们预计未来几年在精神分裂症中发挥更大的作用。此外，由于突出的高风险综合征可以识别精神分裂症风险的青少年，可能以先发制人的方式应用早期的干预以降低残疾，提高适应性。精神分裂症作为具有阶段的发育神经认知障碍的概念开辟了早期干预措施的可能性窗口。 （济恩，2017,23,881-892）

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