Cognitive Impairments in Drug-Naive Patients With First-Episode Negative Symptom–Dominant Psychosis

作者：Tianhong Zhang, YanYan Wei, XiaoChen Tang, HuiRu Cui, YeGang Hu, Lihua Xu, HaiChun Liu, Zixuan Wang, Tao Chen, Qiang Hu, Chunbo Li, Jijun Wang · 发表于：JAMA Network Open · 年份：2024 · DOI：10.1001/jamanetworkopen.2024.15110 · 被引用次数：23 · 研究领域：Schizophrenia research and treatment、Mental Health and Psychiatry、Dementia and Cognitive Impairment Research

Importance: Available antipsychotic medications are predominantly used to treat positive symptoms, such as hallucinations and delusions, in patients with first-episode psychosis (FEP). However, treating negative and cognitive symptoms, which are closely related to functional outcomes, remains a challenge. Objective: To explore the cognitive characteristics of patients with negative symptom-dominant (NSD) psychosis. Design, Setting, and Participants: This large-scale cross-sectional study of patients with FEP was led by the Shanghai Mental Health Center in China from 2016 to 2021, with participants recruited from 10 psychiatric tertiary hospitals. A comprehensive cognitive assessment was performed among 788 patients with FEP who were drug-naive. Symptom profiles were determined using the Positive and Negative Symptoms Scale (PANSS), and NSD was defined as a PANSS score for negative symptoms higher than that for positive and general symptoms. Positive symptom-dominant (PSD) and general symptom-dominant (GSD) psychosis were defined similarly. Data were analyzed in 2023. Exposure: Psychotic symptoms were categorized into 3 groups: NSD, PSD, and GSD. Main Outcomes and Measures: Neurocognitive performance, assessed using the Chinese version of the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery. Results: This study included 788 individuals with FEP (median age, 22 [IQR, 17-28] years; 399 men [50.6%]). Patients with NSD exhibited ...