Neuropoznawczy wymiar schizofrenii – możliwości oceny oraz implikacje terapeutyczne
DOI:
https://doi.org/10.1515/cpp-2017-0005Słowa kluczowe:
schizofrenia, funkcje poznawcze, wczesna interwencjaAbstrakt
Wstęp: W ostatnich dziesięcioleciach uwaga badaczy kieruje się na zaburzenia funkcji poznawczych w schizofrenii. Liczne badania wskazują na istnienie deficytów neuropoznawczych w schizofrenii obejmujących m. in. funkcje motoryczne, uczenie się i pamięć, funkcje wykonawcze, uwagę, język, umiejętności przestrzenne i ogólną inteligencję.
Metoda: Dokonano przeglądu dostępnej literatury tematu piśmiennictwa ostatnich dwóch dekad, dostępnego w bazach Pubmed, EBSCO, SCOPUS- przeszukując je za pomocą słów kluczowych: schizophrenia, cognition, early intervention.
Wyniki: Dysfunkcje poznawcze stanowią ważny element obrazu fazy prodromalnej i pierwszego epizodu schizofrenii. Badacze tematu zaproponowali więc podejmowanie wczesnych interwencji terapeutycznych wobec osób z tak zwanym ryzykownym stanem psychicznym. W artykule zawarto przypomnienie badań nad istotą zaburzeń neuropoznawczych w schizofrenii, definicję oraz przegląd metod stosowanych do identyfikacji określonych deficytów poznawczych oraz zagadnienia ryzyka rozwoju psychozy i wczesnej interwencji terapeutycznej w stanach wysokiego ryzyka.
Wnioski: Doniesienia badaczy wskazują na istotną wagę detekcji zaburzeń poznawczych w początkowym okresie rozwoju schizofrenii. Poszerza to wachlarz oddziaływań terapeutycznych i umożliwia wczesną interwencję w stanach zwiększonego ryzyka rozwoju psychozy.
Bibliografia
1. Kraepelin, E., 1971. Dementia praecox and paraphrenia. Robert E. Krieger Publishing Co. Inc., Huntington, NY.
2. Green M.F., Harvey P.D. Cognition in schizophrenia: Past, present and future. Schizophrenia Research: Cognition 1(2014) e1-e9.
3. Kahn R.S. Dlaczego Kraepelin miał rację: schizofrenia jako zaburzenie poznawcze. Neuropsychiatria i Neuropsychologia 2014; 9, 2: 41-47.
4. Bleuler, E., 1950. Dementia praecox or the group of schizophrenias. International Universities Press, New York, N.Y.
5. Cameron, N., 1939. Schizophenic thinking in a problem-solving situation. Br. J. Psychiatry 85, 1012-1035.
6. Andreasen N.C., Olsen S. Negative versus positive schizophrenia. Definition and validation.Arch. Gen. Psychiatry. 1982; 39(7): 789-794.
7. Crow T.J. Positive and negative schizophrenic symptoms and the role of dopamine. Br. J. Psychiatry. 1980; 137: 383-386.
8. Crow T.J. The two-syndrome concept: origins and current status. Schizophr. Bull. 1985; 11(3): 471-486.
9. Liddle P.F. The symptoms of chronic schizophrenia. A reexamination of the positive-negative dichotomy. Br. J. Psychiatry. 1987; 151: 145-151.
10. Kay S.R. Positive-negative symptom assessment in schizophrenia: psychometric issues and scale comparison. Psychiatr. Q. 1990; 61(3): 163-178.
11. Lindenmayer J.P., Grochowski S., Hyman R.B. Five factor model of schizophrenia: replication across samples. Schizophr. Res. 1995; 14(3): 229-234.
12. APA. DSM-5 Development. 2012; http:www.dsm5.org. (pobrano: 2013-05-10).
13. Green M.F., Kern R.S., Heaton R.K. Longitudinal studies of cognition and functional outcome in schizopfrenia: implications for MATRICS. Schizophr. Res. 2004; 70: 117-145.
14. Green M.F., Schooler N.R., Kern R.D. Evaluation of functionallymeaningful measures for clinical trials of cognition enhancement in schizophrenia. Am. J. Psychiatry. 2011; 168: 400-407.
15. Leung W.W., Bowie C.R., Harvey P.D. Functional implications of neuropsychological normality and symptom remission in older outpatiens diagnosed with schizophrenia: a cross-sectional study. I. Int. Neuropsychol. Soc. 2008; 14: 479-488.
16. Rosenheck R., Leslie D., Keefe R. Barriers to employement for people with schizophrenia. Am. J. Psychiatry. 2006; 163: 411-417.
17. Wciórka J. Psychiatria t. I, Bilikiewicz A., Pużyński S., Rybakowski J., Wciórka J. (red.) Wyd. Urban&Parnter, Wrocław 2002; 333-340.
18. Cutting J. Principles of psychopatology; two worlds - two minds - two hemispheres. Oxford Univ. Press, Oxford 1997.
19. Strelau J. , Doliński D. Psychologia. Podręcznik akademicki. GWP, Gdańsk 2008, t. 2; 429-431.
20. Cowan N. An embedded-processes model of working memory. Models of working memory: Mechanisms of active maintenance and executive control. 1999, Vol. 20; 506
21. Baddeley A., Wilson BA. Prose recall and amnesia: implications for the structure of working memory. Neuropsychologia 2002; 40(10): 1737-43
22. Borkowska A. Neuropsychologiczne i neurobiologiczne aspekty pamięci operacyjnej. Neuropsychiatria i Neuropsychologia. 2006; 1(1): 31-42.
23. Walter H., Wunderlich A.P., Blankenhorn M., Schäfer S., Tomczak R., Spitzer M., Grön G. No hypofrontality, but absence of prefrontal lateralization comparing verbal and spatial working memory in schizophrenia. Schizophr. Res. 2003; 61(2): 175-184.
24. Carter C.S., Perlstein W., Ganguli R., Brar J., Mintun M., Cohen J.D. Fuctional hypofrontality and working memory dysfunction inschizophrenia. Am. J. Psychiatry. 1998; 155(9): 1285-1287.
25. Goldman-Rakic P.S., Muly E.C., Williams G.V. D1 receptors in prefrontal cells and circuits. Brain Res. Rev. 2000; 31: 295-301.
26. Webster M.J., Weickert C.S., Herman M.W., Kleinman J.E. BDNF mRNA expression during postnatal development, maturation and aging of the human prefrontal cortex. Brain Res. Dev. 2002; 139: 139-150.
27. Pawęzka J., Karakuła-Juchnowicz H., Welcz H. Neuroobrazowanie zaburzeń pamięci operacyjnej w schizofrenii: od teorii hipofrontalności do zaburzeń sieci aktywności bazowej. Curr. Probl. Psychiatry, 2014; 15(4):176-183.
28. Ojeda N., Pena J., Schretlen DJ, Sanchez P., Aretouli E., Elizagarate J., Ezcurra J., Gutierrez M. Hierarchical structure of the cognitive processes in schizophrenia: the fundamental role of processing speed. Schizophr Res. 2012 Mar;135(1-3):72-8.
29. Rodriguez-Sanchez JM, Ayesa-Arriola R., Perez-Iglesias R., Perianez JA, Martinez-Garcia O., Gomez-Ruiz E.,Tabares- Seisdedos R., Crespo-Facorro B. Course of cognitive deficits in first episode of non-affective psychosis: a 3-year follow-up study. Schizophr Res. 2013 Oct;150(1):121-8.
30. Bowie C.R., Leung W.W., Reichenberg A., McClure M.M. Predicting schizophrenia patients’ real-world behavior with specific neuropsychological and functional capacity measures. Biol. Psychiatry. 2008; 63: 505-511.
31. Carpenter W.T. Anticipating DSM V: should psychosis risk become a diagnostic class? Schizophr. Bull. 2009; 35: 841-843.
32. Heckers S. Who is at risk for a psychotic disorder? Schizophr. Bull. 2009; 35: 847-850.
33. Rabe-Jabłońska J., Kotlicka-Antczak M. (red.) Ryzykowny stan psychiczny, Wyd. Termedia, Poznań 2012; 19-34.
34. Tsuang M.T., Stone W.S., Faraone S.V. Understanding predisposition to schizophrenia: toward intervention and prevention. Can. J. Psychiatry. 2002b; 47(6): 518-526.
35. Tsuang M.T., Faraone S.V. Diagnostic concepts and prevention of schizophrenia. Can. J. Psychiatry. 2002a; 47(6): 515-517.
36. Fogelson D.L., Nuechterlein K.H., Asarnov R.F., Payne D.L., Subotnik K.L. Validity of the family history method for diagnosisng schizophrenia, schizophrenia-related psychoses, and schizophrenia-spectrum personality dosorders in first-degree relatives of schizophrenia probands. Schizophr. Res. 2004; 68(1-2): 309-317.
37. Krysta K., Krupka-Matuszczyk I., Janas-Kozik M., Stachowicz M., Szymszal J., Rybakowski J. Inferior performance on selected neuropsychologic tests in abstinent schizophrenia patients who have used cannabis. Med. Sci. Manit. 2012; 18(9): 581-586.
38. Lawrie S.M., Olabi B., Hall J., McIntosh A.M. Do we have any evidence of clinical utility about the pathophysiology of schizophrenia? World Psychiatry. 2010; 10: 19-31.
39. Harvey P.D., Starssing M. Predicting the severity of everyday functional disability in people with schizophrenia: cognitive deficits, functional capacity, symptoms and health status. World Psychiatry. 2012; 11(2): 73-79.
40. Kurtz M.M., Tolman A. Neurocognition, insight into illness and subjective quality of life in schizophrenia: what is their relationship? Schizophr. Res. 2011; 127(1-3): 157-162.
41. Borkowska A. Dysfunkcje poznawcze w schizofrenii w ocenie neuropsychologicznej i neurofizjologicznej. Akademia Medyczna w Bydgoszczy, Bydgoszcz 2002.
42. Borkowska A. Zaburzenia funkcji poznawczych w schizofrenii. (w:) Bilikiewicz A., Pużyński S., Rybakowski J., Wciórka J. (red.) Psychiatria t. I. Urban & Partner, Wrocław 2002; 545-548.
43. Waldo M.C., Carrey G., Myles-Worsley M. Codistribustion of a sensory gating in schizophrenic patients and their relatives. Psychiatry Res. 1991; 39: 257-268.
44. Lewis R. Should cognitive deficit be a diagnostic criterion for schizophrenia? J. Psychiatry Neurosci. 2004; 29(2): 102-113.
45. Borkowska A., Rybakowski J. Deficyty poznawcze w schizofrenii. (w:) Borkowska A. (red.) Zaburzenia funkcji poznawczych w chorobach psychicznych. Biblioteka Psychiatrii Polskiej, Kraków 2005; 7-23.
46. Borkowska A. Lateralizacja dysfunkcji psychicznych w schizofrenii w świetle wybranych badań neuropsychologicznych. Praca doktorska. Akademia Medyczna w Bydgoszczy, Bydgoszcz 1996.
47. Heinrichs R.W., Zakzanis K.K. Neurocognitive deficit in schizophrenia: a quantative review of the evidence. Neuropsychology. 1998; 12(3): 426-445.
48. Bilder R.M., Reiter G., Bates J., Lencz T., Szeszko P., Goldman R.S. Robinson D., Lieberman J.A., Kane JM. Cognitive development in schizophrenia: follow-back from the first episode. J. Clin. Experim. Neuropsychology. 2006; 28(2): 270-282.
49. Byrne M., Hodges A., Grant E., Owens D.C., Johnstone E.C. Neuropsychological assessement of young people at high genetic risk for developing schizophrenia compared with controls: preliminary findings of the Edinburgh High Risk Study (EHRS). Psychol. Med. 1999: 29(5): 1161-1173.
50. Cannon T.D., Bearden C.E., Hollister J.M., Rosso I.M., Sanches L.E., Headley T. Childhood cognitive functioning in schizophrenia patients and their unaffected siblings: a prospective cohort study. Schizophr. Bull. 2000a; 26(2): 379-393.
51. Cornblatt B.A., Keilp J.G. Impaired attention, genetics, and the pathophysiology of schizophrenia. Schizophr. Bull. 1994; 20(1): 31-46.
52. Seidman L.J., Giuliano A.J., Meyer E.C., Addington J., Cadenhead K.S., Cannon T.D., McGlashan T.H., Perkins D.O., Tsuang M.T., Walker E.F., Woods S.W., Bearden C.E., Christensen B.K., Hawkins K., Heaton R., Keefe R.S.E., Heinssen R., Cornblatt B.A. Neuropsychology of the prodrome to psychosis in the NAPLS consortium: relationship to family history and conversion to psychosis. Arch. Gen. Psychiatry. 2010; 67(6): 578-588.
53. Meltzer H.Y. Cognitive factors in schizophrenia: causes, impact and treatment. CNS Spectr. 2004; 9: 15-24.
54. Asarnov R.F., Asamen J., Granholm E., Sherman T., Watkins J.M., Williams M.E. Cognitive/neuropsychological studies of children with a schizophrenic disorder. Schizophr. Bull. 1994; 20(4): 647-669.
55. Banaschewski T. Schultz E., Martin M., Remschmidt H. Cognitive functions and psychopathological symptoms in early-onset schizophrenia. Eur. Child Adolesc. Psychiatry. 2000; 9(1): 11-20.
56. Øie M., Rund B.R. Neuropsychological deficits in adolescent-onset schizophrenia compared with attention deficit hyperactivity disorder. Am. J. Psychiatry. 1999; 15(8): 1216-1222.
57. Woodberry K.A., Giuliano A.J., Seidman L.J. Premorbid IQ in schizophrenia: a meta--analytic review. Am. J. Psychiatry. 2008; 165(5): 579-587.
58. Graham F.K. The more or less startling effects of weak prestimulation. Psychophysiology. 1975; 12: 238-248.
59. Light G.A., Swerdlow N.L., Rissling A.J., Radant A., Sugar C.A., Sprock J., Pela M., Geyer M.A., Braff D.L. Characterization of neuropsychologic and neurocognitive biomarkers for use in genomic and clinical outcome studies of schizophrenia. PLoS One. 2012; 7(7): e39434.
60. Rissling A.J., Makeig S., Braff D.L., Light G.A. Neurophysiologic markers of abnormal brain activity in schizophrenia. Curr. Psychiatry Rep. 2010; 12(6): 572-578.
61. Karakuła H. Poszukiwanie wskaźników genetycznej podatności na schizofrenię. Rozprawa habilitacyjna. Akademia Medyczna, Lublin 2007.
62. Lin Y.T., Liu C.M., Chiu M.J., Liu C.C., Chien Y.L., Hwang T.J., Jaw F.S., Shan J.C., Hsieh M.H., Hwu H.G. Differentiation of schizophrenia patients from healthy subjects by mismatch negativity and neuropsychological tests. PLoS One. 2012; 7(4): e34454.
63. Souza V., Muir W., Walker M., Glabus M., Roxborough H., Sharp C., Dunan J., Blackwood D. Auditory P300 event-realted potentials and neuropsychological performance in schizophrenia and bipolar affective disorders. Boil. Psychiatry. 1995; 37: 300-310.
64. Wynn J.K., Dawson M.E., Schell A.M., McGee M., Salveson D., Green M.F. Prepulse facilitation and prepulse inhibition in schizophrenia patients and their unaffected siblings. Biol. Psychiatry. 2004; 55: 518-523.
65. Rassovsky Y., Green M.F., Nuechterlein K.H., Breitmeyer B., Mintz J. Paracontrast and metacontrast in schizophrenia: claryfing the mechanism of visual masking deficits. Schizophr. Res. 2004; 71: 485-492.
66. Bilder R.M., Lipschultz-Broch L., Reiter G., Geisler S.H., Mayerhoff D.I., Lieberman J.A. Intellectual deficits in the first-episode schizophrenia: evidence for progressive deterioration. Schizophr. Bull. 1992; 18: 437-448.
67. Frangou S., Hadjulis M., Vourdas A. The Maudsley Early Onset Schizophrenia Study: cognitive function over a 4-year follow-up study. Schizophr. Bull. 2008; 34(1): 52-59.
68. Saykin A.J., Shtasel D.L., Gur R.E., Kester D.B., Mozley L.H., Stafiniak P., Gur R.C. Neuropsychological deficits in neuroleptic naïve patients with first-episode schizophrenia. Arch. Gen. Psychiatry. 1994; 51: 124-131.
69. Cornblatt B.A., Malhotra A.K. Impaired attention as an ednophenotype for molecular genetic studies of schizophrenia. Am. J. Med. Gen. 2001; 105: 11-15.
70. Addington J., Saedi H., Addington D. The course of cognitive functioning in the first episode psychosis: changes over time and impact on outcome. Schizophr. Res. 2005; 78: 35-43
71. Gold S., Arndt S., Nopoulos P., O’Leary D., Andreasen N. Longitudinal study of cognitive function in first-episode and recent-onset schizophrenia. Am. J. Psychiatry. 1999; 156: 1342-1348.
72. Bowie C.R., McLaughlin D., Carrion R.E., Auther A.M., Cornblatt B.A. Cognitive changes following antidepressant or antipsychotic treatment in adolescents at clinical risk for psychosis. Schizphr. Res. 2012; 137(1-3): 110-117.
73. Brewer W.J., Wood S.J., Philips L.J., Francey S.M., Pantelis C., Yung A.R., Cornblatt B., McGorry P.D. Generalized and specific cognitive performance in clinical high cohorts: a review highlighting potential vulnerability markers for psychosis. Schizophr. Bull. 2006; 32(3): 538-555.
74. Harvey P.D. When does cognitive decline occur in the period to the first episode of schizophrenia? Psychiatry (Edgmont). 2009; 6: 12-14.
75. Hoff A.L., Svetina C., Shields G., Steward J., DeLisi L.E. Ten year longitudinal study of neuropsychological functioning subsequent to a first episode of schizophrenia. Schizophr. Res. 2005; 78: 27-34.
76. Kurtz M.M. Neurocognitive impairment across the lifespan in schizophrenia: an update. Schizophr. Res. 2005; 74: 15-26.
77. Stirling J., White C., Lewis S., Hopkins R., Tantam D., Huddy A., Montague L. Neurocognitive function and outcome in the firstepisode schizophrenia: a 10-year follow--up of an epidemiological cohort. Schizophr. Res. 2003; 65(2-3): 75-86.
78. Keefe R.S., Buchanan R.W., Marder S.R., Schooler N.R., Dugar A., Zivkov M., Stewart M. Clinical trials of potential cognitiveenhancing drugs in schizophrenia: what have we learned so far? Schizophr. Bull. 2011; 39(2): 417-435.
79. Marder S.R. Lessons from MATRICS. Schizophr. Bull. 2011; 37(2): 233-234.
80. Shamsi S., Lau A., Lencz T., Burdick K.E., DeRosse P., Brebber R., Lindenmayer J.P., Malhotra A.K. Cognitive and symptomatic predictors of functional disability in schizophrenia. Schizophr. Res. 2011; 126(1-3): 257-264.
81. Kern R., Neuchterlein K., Green M., Baade L., Fenton W., Gold J., Keefe R., Meshoalm-Gateley R., Mintz J., Seidman L., Stover E., Marder S. The MATRICS cognitive battery, part 2-co norming and standardization. Am. J. Psychiatry 2008; 165: 214-220.
82. McGorry P.D., Edwards J., Mihalopoulos C., Harrigan S., Jackson H.J. EPPIC: an envolving system of early detection and optimal management. Schizophr. Bull. 1996; 22: 305-326.
83. McGorry P.D., Killackey E., Yung A. Early intervention in psychosis: concepts, evidence and future directions. World Psychiatry. 2008; 7(3): 148-156.
84. Yung A.R., Philips L.J., Nelson B., Francey S.M., PanYuen H., Simmons M.B., Ross M.L., Kelly D., Baker K., Amminger G.P., Berger G., Thompson A.D., Thampi A., McGorry P.D. Randomised controlled trial of interventions for young people at ultra high risk for psychosis: a 6- month analysis. J. Clin. Psychiatry. 2011; 72(4): 430-440.
85. Cornblatt B.A., ObuchowskiM. Roberts S., Pollack S., Erlenmeyer- Kimliong L. Cognitive and behavioral precursors of schizophrenia. Dev. Psychopathol. 1999; 11(3): 487-508.
86. Yung A.R., McGorry P.D. The initial prodrome in psychosis: descriptive and qualitative aspects. Aust. N. Z. J. Psychiatry. 1996; 30: 587-599.
87. Rabe-Jabłońska J., Kotlicka-Antczak M., Gmitrowicz A. Obraz kliniczny i czas trwania objawów zwiastunowych w schizofrenii u młodzieży. Psychiatria Pol. 1999; 33(5): 715-725.
88. Szulc A., Czernikiewicz A. Stany prepsychotyczne - współczesne koncepcje diagnostyczne i terapeutyczne. Część II. Markery biologiczne ryzyka rozwoju schizofrenii. Terapia stanów prepsychotycznych. Psychiatria Pol. 2007; 1: 17-21.
89. van Os J., Hanssen M., De Graff I., Vollebergh W. Does the urban environment independently increase the risk for both negative and positive features of psychosis? Soc. Psychiatry Psychiatr. Epidemiol. 2002; 37(10): 460-464.
90. Birchwood M., Fowler D., Jackson C. (eds.) Early intervention in psychosis: guide to concepts, evidence and intervention. Wiley, Chichester City, UK 2000.
91. Bottlender R., Sato T., Jager M. The impact of the duration of untreated psychosis prior to first psychiatric admission on the 15-year outcome in schizophrenia. Schizophr. Res. 2009; 62: 37-44.
92. Joseph. R., Birchwood M. The national policy reforms for mental health services and the story of early intervention services in the United Kingdom. J.Psychiatry Neurosci. 2005; 30: 362-365.
93. Kuipers E., Holloway F., Rabe-Hesketh S., Tennakoon L. An RCT of early intervention in psychosis: Ceaydon Outreach and Assertive Support Team (COAST). Soc. Psychiatr. Epidemiol. 2004; 39: 359-363.
94. Craig T., Garety P., Power P., Rahaman N., Colbert S., Fornells- Ambroyo M., Dunn G. The Lambeth Early Onset Team: randomized, controlled trial of the effectiveness of specialized care for early psychosis. Br. M. Journal. 2004; 329: 1067-1071.
95. Petersen L., Jeppesen P., Thorup A., Abel M.B., Øhlenschlaeger J., Christensen T.Ø., Krarup G., Jørgensen P., Nordentoft M. A randomized, multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness. Br. M. Journal. 2005; 331: 602-608.
96. Grawe R.W., Falloon I.R., Widen J.H., Skogvoll E. Two years of continued early treatment for recent-onset schizophrenia: a randomized controlled study. Acta Psychiatr. Scand. 2006; 114: 328-336.
97. Bird V., Premkumar T., Kendall C., Whittington J., Mitchel J., Kuipers E. Early intervention services, cognitive-behavioural therapy and family intervention in early psychosis: systemic review. Br. J. Psychiatry. 2010; 197: 350-356.
98. Carrión R.E., Cornblatt B.A., Burton C.Z., Tso I.F., Auther A.M., Adelsheim S., Calkins R., Carter C.S., Niendam T., Sale T.G., Taylor S.F., McFarlane W.R. Personalized Prediction of Psychosis: External Validation of the NAPLS-2 Psychosis Risk Calculator With the EDIPPP Project. American Journal of Psychiatry. Volume 173, Issue 10, October 01, 2016, pp. 989-996
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