Comparative Study Of Cognitive Function In First-episode Schizophrenia And Ultra High Risk Population

BackgroundSchizophrenia is one of the common psychiatric diseases, which often get the onset in young adults’period, and with the performance of unknown etiology, long course of disease and recurrent attacks. This is a public consensus that there are three main symptoms of Schizophrenia:negative, positive symptoms and social function damage.Foreign scholars defined the "prodromal stage"of schizophrenia through kinds of study, which is a period (1-5 years) from personality generation and behavior change to the first time onset of disease. And high or ultra high risk population refers to the population who are in the "prodromal stage"of schizophrenia. Study based on cognitive function among ultra high risk groups, the first onset schizophrenia patients and normal people, can help to detect the early symptoms of schizophrenia.ObjectiveResearch on the features of cognitive impairment between schizophrenia ultra high-risk groups and the first onset patients, with the purpose of providing the theory basis evidence for early detection and early diagnosis of schizophrenia, at the same time can provide thinking method to prevent the occurrence of schizophrenia.MethodsThe study begins from July 2013, and all research objects have been selected into the group until October 2014. All subjects included in the standard:age,16～30 years old (including 16 and 30), signed a informed consent form of entering group (comply with ethics), volunteered to join the study, to be able to comply with the terms of the research plan, intelligence quotient (IQ) within the normal range (IQ 80 points or more), the education years for more than 12 years (that is, senior high school degree or above),know the baseline assessment and follow-up survey respondents, and to complete the questionnaire. Exclusion criteria:organic disease, pregnancy and lactation, nervous system diseases such as idiopathic epilepsy history, also ruled out other serious body disease and non addictive substances or other mental active substance dependence or abuse. The ultra high-risk group:to screen firstly at a large area in Luoyang Fifth People’s Hospital, The Second Rongkang Hospital of Henan Province, Luoyang Psychological Association Consultancy, Yichuan County Psychiatric Hospital and Yiyang County Psychiatric Hospital between July 2013-July 2014, and case study screening table adopts the PRIME (filter entries-revised edition), and use the Structured Interview for Prodromal Symptoms (SIPS) interviews on a prodromal stage of schizophrenia, especially for the patients with schizophrenia in first-degree relatives of patients (patients’children or brothers and sisters). According to the COPS (psychosis risk syndrome standard), it must conform to at least one standard of three kinds, and totally 40 cases are selected into a group. The first group:40 schizophrenia patients in the outpatient clinic of Luoyang Fifth People’s Hospital between October 2013-October 2014, they are first onset and never being treatment before. It conforms to the USA diagnostic and Statistical Manual of mental disorders Fourth Edition (DSM-IV) diagnostic criteria.The normal group:the normal 40 cases who don’t have history of mental illness in the family are solicitated through the network, posters and youth staff participation during May 2014～July 2014. Symptom assessment is completed by thirteen psychiatric doctors after the standardized training. Cognitive function assessment tools adopt the standardization of measuring tool of schizophrenia cognitive curative effect evaluation:Schizophrenia MATRICS consensus cognitive battery (MCCB), Formulated by the Second Xiangya Hospital of Centual South University,including the trail making test, symbol coding, Hopkins Verbal Learning Test. Revised (HVLT-R), Brief Visuospatial Memory Test-revised (BVMT-R), Continous Performance Test (CPT), Stroop color word test. The assessment is completed by two trained neural psychological measurement researchers, and whole data results of this study are dealed with SPSS 17.0 software.Results1. Comparison of MCCB test results between groups According to the test records of the trail making test and the symbol encoding between three groups, the test scores of ultra high risk group were significantly higher than those of the first group and significantly lower than the normal group (P<0.01); the HVLT-R score (total) of ultra high risk group was significantly higher than those of the first group and significantly lower than the normal group (P<0.01), the first group and the ultra high risk group showed no significant according to the difference of significance (P>0.05); the BVMT-R scores (total) of ultra high risk group and the normal group were significantly better than the first group (P<0.01), and there was no significant difference between normal group and ultra high risk group (P>0.05); except for ultra high risk group and the normal group, other comparison all had significant differences (P<0.01) in CPT (average) test.2. Comparison of Stroop test results between groups According to the words results comparison between three groups, the records of the normal group and ultra high risk group were significantly better than the first group (P<0.01). There was no significant difference between the normal group and ultra high risk group.The coloe test score of ultra high risk group was significantly higher than that of the first group and significantly lower than the normal group (P<0.01). The color word score of first group was significantly lower than the normal group and ultra high risk group. There was no significant difference between ultra high risk group and the first group (P>0.05).3. The MCCB testing results of the first group of patients with and without a family history:As the differences of the records of trail making test and the symbol encoding between the two groups are not apparent(P>0.05), the results have no statistical significance; the scores of HVLT-R score (total score), CPT(average) are distinctly different(.P<0.01); the differences between the two groups BVMT-R(total) scores are significant, so the results have the statistical significance. Because there are apparent differences between the scores of the Stroop color word tests (P<0.01), the differences between the colors, the color word testing scores are not (P>0.05), so no statistical significance.4. The first group’s MCCB testing results before and after the curing:the HVLT-R scores comparing between the two groups has no statistical significance(P>0.05); the scores of the trail making test, symbol encoding, CPT and Stroop color word testing after the curing are much higher than that before the curing(P<0.01); as the comparing scores of the BVMT-R(total) are different, the results have statistical significance.Conclusions1. Cognitive defects in speed of information processing, attention alert, working memory, verbal memory and so on not only exist in the patients with first-episode schizophrenia, but also in schizophrenia ultra high-risk groups. Cognitive function with first-episode schizophrenia is impaired most seriously.2. The damage of cognitive function in patients with a family history of mental illness schizophrenia is more serious.3. Cognitive function of patients with first-episode schizophrenia can be improved after drug treatment; recovery of the working memory significantly.