Neurocognitive skills and vulnerability for psychosis in depression and across the psychotic spectrum: findings from the PRONIA Consortium,The British Journal of Psychiatry

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Neurocognitive skills and vulnerability for psychosis in depression and across the psychotic spectrum: findings from the PRONIA Consortium
The British Journal of Psychiatry ( IF 10.5 ) Pub Date : 2023-10-17 , DOI: 10.1192/bjp.2023.98
Carolina Bonivento ₁ , Lana Kambeitz-Ilankovic ₂ , Eleonora Maggioni ₃ , Stefan Borgwardt ₄ , Rebekka Lencer ₅ , Eva Meisenzahl ₆ , Joseph Kambeitz ₇ , Stephan Ruhrmann ₈ , Raimo K R Salokangas ₉ , Alessandro Bertolino ₁₀ , Alexandra Stainton ₁₁ , Julian Wenzel ₈ , Christos Pantelis ₁₂ , Stephen J Wood ₁₃ , Rachel Upthegrove ₁₄ , Nikolaos Koutsouleris ₁₅ , Paolo Brambilla ₁₆ ,

Affiliation

Scientific Institute, IRCCS E. Medea, Pasian di Prato, Udine, Italy.
Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany; and Faculty of Psychology and Educational Sciences, Department of Psychology, Ludwig-Maximilian University, Germany.
Department of Electronics, Information and Bioengineering, Politecnico di Milano, Italy.
Translational Psychiatry Unit, Department of Psychiatry and Psychotherapy, University of Lübeck, Germany.
Institute for Translational Psychiatry, Münster University, Germany.
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Germany.
Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany; and Cognitive Neuroscience (INM-3), Institute of Neuroscience and Medicine, Research Center Jülich, Germany.
Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany.
Department of Psychiatry, University of Turku, Finland.
Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Italy.
Orygen, Melbourne, Australia; and Centre for Youth Mental Health, University of Melbourne, Australia.
Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Australia.
Orygen, Melbourne, Australia; School of Psychology, University of Birmingham, UK; and Centre for Youth Mental Health, University of Melbourne, Australia.
School of Psychology, University of Birmingham, UK; Institute for Mental Health, University of Birmingham, UK; and Centre for Human Brain Health, University of Birmingham, UK.
Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Germany; Max Planck Institute for Psychiatry, Germany; and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy; and Department of Pathophysiology and Transplantation, University of Milan, Italy.

Background

Neurocognitive deficits are a core feature of psychosis and depression. Despite commonalities in cognitive alterations, it remains unclear if and how the cognitive deficits in patients at clinical high risk for psychosis (CHR) and those with recent-onset psychosis (ROP) are distinct from those seen in recent-onset depression (ROD).

Aims

This study was carried out within the European project ‘Personalized Prognostic Tools for Early Psychosis Management’, and aimed to characterise the cognitive profiles of patients with psychosis or depression.

Method

We examined cognitive profiles for patients with ROP (n = 105), patients with ROD (n = 123), patients at CHR (n = 116) and healthy controls (n = 372) across seven sites in five European countries. Confirmatory factor analysis identified four cognitive factors independent of gender, education and site: speed of processing, attention and working memory, verbal learning and spatial learning.

Results

Patients with ROP performed worse than healthy controls in all four domains (P < 0.001), whereas performance of patients with ROD was not affected (P > 0.05). Patients at CHR performed worse than healthy controls in speed of processing (P = 0.001) and spatial learning (P = 0.003), but better than patients with ROP across all cognitive domains (all P ≤ 0.01). CHR and ROD groups did not significantly differ in any cognitive domain. These findings were independent of comorbid depressive symptoms, substance consumption and illness duration.

Conclusions

These results show that neurocognitive abilities are affected in CHR and ROP, whereas ROD seems spared. Although our findings may support the notion that those at CHR have a specific vulnerability to psychosis, future studies investigating broader transdiagnostic risk cohorts in longitudinal designs are needed.

中文翻译：

抑郁症和整个精神病谱系中精神病的神经认知技能和脆弱性：PRONIA 联盟的研究结果

背景

神经认知缺陷是精神病和抑郁症的核心特征。尽管认知改变存在共性，但尚不清楚临床精神病高危患者 (CHR) 和新发精神病 (ROP) 患者的认知缺陷是否以及如何与新发抑郁症 (ROD) 患者不同。

目标

这项研究是在欧洲项目“早期精神病管理的个性化预后工具”内进行的，旨在描述精神病或抑郁症患者的认知特征。

方法

我们检查了五个欧洲国家七个地点的ROP 患者 ( n = 105)、ROD 患者 ( n = 123)、CHR 患者 ( n = 116) 和健康对照 ( n = 372) 的认知概况。验证性因素分析确定了四个独立于性别、教育和地点的认知因素：处理速度、注意力和工作记忆、语言学习和空间学习。

结果

ROP 患者在所有四个方面的表现都比健康对照差 ( P < 0.001)，而 ROD 患者的表现未受影响 ( P > 0.05)。CHR 患者在处理速度 ( P = 0.001) 和空间学习 ( P = 0.003) 方面比健康对照组表现较差，但在所有认知领域都优于 ROP 患者（所有P ≤ 0.01）。CHR 组和 ROD 组在任何认知领域都没有显着差异。这些发现与共病抑郁症状、物质消耗和病程无关。

结论

这些结果表明，CHR 和 ROP 的神经认知能力受到影响，而 ROD 似乎没有受到影响。尽管我们的研究结果可能支持这样的观点，即 CHR 的人员对精神病具有特定的脆弱性，但未来的研究需要在纵向设计中调查更广泛的跨诊断风险群体。

更新日期：2023-10-17

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