没有证据表明第一个情节精神病的认知能力下降:长期纵向研究的元分析
Cemal Demirlek1, Matcheri S Keshavan1, Robin M Murray2
1Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
Schizophrenia bulletin
|December 22, 2025
概括
精神分裂症的认知缺陷在十年内保持稳定,从实践效应中获得了适度的收益,而不是神经退行. 这些发现支持精神分裂症的神经发育模型.
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.
- 认知心理学 认知心理学
背景情况:
- 认知缺陷是精神分裂症谱系障碍的核心特征,在第一发精神病 (FEP) 的早期出现.
- 以前的研究表明认知稳定性,但往往缺乏长期跟踪和与健康对照 (HC) 的直接比较.
研究的目的:
- 与健康对照组 (HCs) 相比,在患有第一发精神病 (FEP) 的患者中描述长期认知轨迹.
- 调查FEP认知缺陷是否在长时间内 (长达25年) 进展或保持稳定.
主要方法:
- 根据PRISMA-2020指南,对近期发病精神病的认知进行纵向研究的系统审查和元分析.
- 包括49个数据集 (3693个FEP,1399个HC),随访时间从2年到25年.
- 随机效应的元分析用于评估短期,中期和长期间隔的群体内部变化和群体之间的差异.
主要成果:
- 在长期内,FEP患者和HC患者表现稳定或略有改善的认知表现,没有逐渐恶化的证据.
- 在所有随访间隔中,在FEP患者和HC之间没有发现全球认知变化的显著差异.
- 与对照组相比,注意力是FEP患者改善的唯一领域;症状变化与认知变化无关.
结论:
- 在FEP中神经心理表现至少在十年内基本稳定,可能由于实践效应而有轻微改善.
- 这些发现表明精神分裂症的认知缺陷是特征性的,而不是神经退行过程的迹象.
- 这些结果支持精神分裂症的神经发育模型,而不是神经退行性模型.
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