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Abstract：
While cognitive impairments are prevalent in first-episode psychosis, the course of these deficits is not fully understood. Most deficits appear to remain stable, however there is uncertainty regarding the trajectory of specific cognitive domains after illness onset. This study investigates the longitudinal course of cognitive deficits four years after a first-episode of psychosis and the relationship of performance with clinical course and response to treatment. Twenty three individuals with psychotic illness, matched with 21 healthy volunteers, were assessed using the MATRICS Consensus Cognitive Battery at illness onset and 4 years later. We also investigated the relationship between cognitive deficits and quality of life and clinical indices. Verbal learning and two measures of processing speed had marked poorer trajectory over four years compared to the remaining cognitive domains. Processing speed performance was found to contribute to the cognitive deficits in psychosis. Poorer clinical outcome was associated with greater deficits at illness onset in reasoning and problem solving and social cognition. Cognitive deficits did not predict quality of life at follow-up, nor did diagnosis subtype differentiate cognitive performance. In conclusion, an initial psychotic episode may be associated with an additional cost on verbal learning and two measures of processing speed over a time spanning at least four years. Moreover, processing speed, which has been manipulated through intervention in previous studies, may represent a viable therapeutic target. Finally, cognition at illness onset may have a predictive capability of illness course.
摘要：
虽然认知障碍在首发精神病中普遍存在，这些赤字的过程还没有被完全理解。大多数赤字似乎保持稳定，然而,发病后特定认知域的轨迹存在不确定性.这项研究调查了精神病首次发作后四年认知缺陷的纵向过程，以及表现与临床过程和对治疗反应的关系。23名精神病患者，与21名健康志愿者相匹配，在发病时和4年后使用MATRICS共识认知电池进行评估。我们还调查了认知缺陷与生活质量和临床指标之间的关系。与其余认知领域相比，言语学习和两种处理速度指标在四年内的轨迹明显较差。发现处理速度表现有助于精神病的认知缺陷。较差的临床结果与疾病发作时在推理，解决问题和社会认知方面的更大缺陷有关。认知缺陷并不能预测随访时的生活质量，诊断亚型也没有区分认知表现。总之,最初的精神病发作可能与口头学习的额外成本以及至少四年时间内的两项处理速度指标相关。此外，处理速度,在以前的研究中通过干预被操纵，可能代表可行的治疗靶标。最后,发病时的认知可能对病程有预测能力。
