| Objective:The study investigated the differences of cognitive functions and psychological status among ultra high-risk groups,first-degree relatives of schizophrenia,first-episode schizophrenia patients,multi-episode schizophrenia patients and healthy controls.And to explore the psychopathological related endophenotypes for ultra high-risk.To achieve early identification,diagnosis and intervention in the subclinical trait or prodromal,provide the basis of intervention for ultra high-risk,improve the poor prognosis and reduce functional disability.Methods:40 participants meeting clinical inclusion criteria for initial prodromal states (IPS) selected from the first degree relatives of schizophrenia,40 first-degree relatives of schizophrenia(high-risk groups),40 first-episode schizophrenia patients,40 multi-episode schizophrenia patients as well as 40 healthy controls were assessed with the following items.(1)All of the subjects was assessed of the general situation and psychopathologic symptoms.General situation by using self-made questionnaire of general demography data; symptomatology was assessed using the Montgomery-Asberg Depression Scale (MADRS),and positive and negative symptom scale (PANSS).(2)All of the subjects was assessed with the psychological assessment tools including Childhood Trauma Questionnaire(CTQ),Family Adaptability and Cohesion Scale,second edition(FACESII-CV),Life Event Scale(LES),Social Support Scale(SSS),Rosenberg Self-Esteem Scale(SES),and Coping style questionaire(CSQ).(3)A battery of comprehensive neurocognitive test was used to measure five cognitive domains in matched groups consisting of 40 subjects each. Cognitive tests included the trail making test A(TMTA),the symbol coding Test,the Hopkins verbal learning test-revised(HVLT-R),the brief visuospatial memory test-revised(BVMT-R),the Stroop color word test,and the continuous performance test(CPT).To investigated the differences of cognitive functions and mental status among ultra high-risk groups, high-risk groups, first-episodschizophrenia patients,multi-episode schizophrenia patients and healthy controls.Results:1.Comparison of symptomatology:There were statistically significant (p<0.05) in MADRS and PANSS scores among ultra high-risk group and other groups.The symptomatology of ultra high-risk group were better than that of first-episode schizophrenia patients and multi-episode schizophrenia patients, but worse than high-risk groups and healthy controls.2. Comparison of psychology:(1)Childhood Trauma Questionnaire results showed that ultra high-risk groups scored significantly lower than first-episode schizophrenia patients,multi-episode schizophrenia patients,and healthy controls (p <0.05),but no significant in high-risk groups(p>0.05).(2)Intimacy scores of FACESII-CV showed that there was no significant difference among ultra high-risk groups,high-risk groups,first-episode schizophrenia patients,and multi-episode schizophrenia patients(p>0.05),but healthy controls was significantly higher than other groups. Adaptive scores of FACESII-CV showed that ultra high-risk groups and healthy controls was significantly higher than high-risk groups,first-episode schizophrenia patients and multi-episode schizophrenia patients(p<0.05).(3)Life Event Scale results showed no significant differences in each dimension(p>0.05). (4)Social Support Scale showed that ultra high-risk groups and high-risk groups scored significantly higher than first-episode schizophrenia patients and multi-episode schizophrenia patients,but statistically lower than healthy controls(p<0.05).(5) Rosenberg Self-Esteem Scale showed that ultra high-risk groups and scored significantly higher than high-risk groups,first-episode schizophrenia patients and multi-episode schizophrenia patients, but no significant differences with healthy controls.(6)Problem-solving dimension of coping style questionnaire showed that ultra high-risk groups,high risk groups and healthy controls was significantly higher than first-episode schizophrenia patients and multi-episode schizophrenia patients.Remorse dimension of coping style questionnaire showed that ultra high-risk groups,high risk groups and healthy controls was significantly lower than first-episode schizophrenia patients and multi-episode schizophrenia patients.Seek help dimension of coping style questionnaire showed that ultra high-risk groups,high risk groups and healthy controls was significantly lower than first-episode schizophrenia patients and multi-episode schizophrenia patients.Illusion dimension of coping style questionnaire showed that healthy controls was significantly lower than other groups.Retreat dimension of coping style questionnaire showed that healthy controls was significantly lower than high risk groups,first-episode schizophrenia patients and multi-episode schizophrenia patients.3.Comparison of cognitive performances(1)The peoformance of TMTA showed that ultra high-risk groups scored significantly shorter than the first-episode schizophrenia patients and the multi-episode schizophrenia patients, but statistically higher than high-risk groups and healthy controls(p<0.05).(2)The peoformance of symbol coding test showed that ultra high-risk groups scored significantly higher than the first-episode schizophrenia patients and the multi-episode schizophrenia patients, but statistically lower than high-risk groups and healthy controls(p<0.05).(3)The peoformance of HVLT-R showed that The high-risk groups and healthy controls showed significantly higher scores,as well as ultra high-risk groups,first-episode schizophrenia patients and multi-episode schizophrenia patients showed lower scores(p<0.05).(4)The peoformance of BVMT-R showed that ultra high-risk groups and high-risk groups significantly higher than the first-episode schizophrenia patients and the multi-episode schizophrenia patients, but statistically lower than healthy controls(p<0.05).(5)The peoformance of Stroop color word test showed that ultra high-risk groups scored significantly higher than the first-episode schizophrenia patients and the multi-episode schizophrenia patients, but statistically lower than high-risk groups and healthy controls(p<0.05).(6)The peoformance of CPT showed that ultra high-risk groups scored significantly better than the first-episode schizophrenia patients and the multi-episode schizophrenia patients,well statistically poorer than high-risk groups and healthy controls(p<0.05).Conclusion:1.The psychiatric symptoms were already present in the ultra high-risk for psychosis, but not yet reached the diagnostic criteria.2.Intimacy and social support has a certain influence on ultra high-risk for psychosis.Ultra high-risk more took immature coping styles, as well as immature coping style in turn affects the Genetic quality psychiatric ultra high-risk itself also affects their cognitive function for psychosis.3.Ultra high-risk for psychosis showed extensive impairment in cognitive functions. Cognitive dysfunction is one of the potential predictors of psychiatric transformation.This study showed the consideration of processing speed as a potential psychopathological related endophenotype.4.High-risk groups also showed extensive impairment in cognitive functions,but the severity of light to psychosis at ultra high risk. |
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