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早期干预对第一次精神病发作对认知功能的影响
Kim T Mueser1, Rachel F Sussman2, Nicole R DeTore3
1Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA; Department of Occupational Therapy, Boston University, Boston, MA, USA.
Schizophrenia research
|September 1, 2023
概括
早期干预服务 (EIS) 对精神分裂症患者的认知益处有限. 虽然患有第一发精神病 (FEP) 的年轻人看到了工作记忆的改善,但与常规护理相比,老年患者在认知上没有从EIS中受益.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
背景情况:
- 认知障碍是精神分裂症的主要特征,从疾病发作开始就明显.
- 众所周知,早期干预服务 (EIS) 可以改善第一发精神病 (FEP) 的症状和功能.
- 对于EIS对FEP认知功能的具体影响仍未得到充分研究.
研究的目的:
- 评估FEP患者的长期认知变化,在对照试验中将EIS与标准护理进行比较.
- 为了确定EIS是否增强了经历第一次精神病发作的人的认知功能.
主要方法:
- 一个集群随机对照试验,涉及34个美国社区心理健康中心的404名FEP患者 (15-40岁).
- 参与者接受了两年的EIS计划 (NAVIGATE) 或通常的社区护理 (CC).
- 在基线,1年和2年随访期间,使用精神分裂症认知简要评估 (BACS) 测量认知功能.
主要成果:
- 较老的FEP患者 (≥20岁) 在所有BACS测试中都表现出改善,无论治疗组如何.
- 在NAVIGATE组中,年轻的FEP患者 (15-19岁) 与CC组相比,工作记忆 (数字测序) 的改善显著更大.
- 主要在第一年内观察到认知能力的提高,与症状严重程度的降低相关.
结论:
- 对于老年FEP患者来说,EIS没有比通常的护理产生更好的认知效益.
- 在年轻的FEP患者中,EIS可能为工作记忆提供特定的优势.
- 针对性认知干预可能是必要的,以全面改善大多数FEP患者的认知功能.
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