Abstract
Aim. To assess the association of clinical and therapeutic parameters with the severity of the neurocognitive deficits in patients with schizophrenia. Materials and methods. We examined 118 patients with schizophrenia, aged 34 [29; 41] years, and with a disease duration of 10 [4; 16] years. 33 patients (28%) received conventional antipsychotic drugs (CAD), and 85 (72%) patients received atypical antipsychotic drugs (AAD). As concomitant therapy, 58 people (49.1%) took trihexyphenidyl, 60 people did not take it (50.9%). Assessment of cognitive functions was carried out for all patients using the Brief Assessment of Cognition in Schizophrenia (BACS), and clinical psychopathological symptomatology was evaluated using the Positive and Negative Syndrome Scale (PANSS). Statistical analysis of the data was performed using the Kruskal-Wallis test ANOVA with the multiple comparison procedure, the Pearson’s chi-squared test, and K-means cluster analysis. Results. Neurocognitive deficits formed three clusters of disturbances that differ in clinical severity: 1) mild, 2) moderate, 3) severe. According to the subscale of positive PANSS symptoms, patients with mild neurocognitive deficits had a lower average total score compared to patients with severe neurocognitive deficits ( p = 0.011), who, in turn, received significantly longer antipsychotic therapy compared with patients with moderate ( p = 0.014) and mild ( p = 0.01) neurocognitive deficits. Herewith, the duration of CAD treatment did not differ between clusters; consequently, the obtained results on antipsychotics as a whole were obtained due to AAD ( p = 0.005 and p = 0.001, respectively). Trihexyphenidyl did not affect the severity of neurocognitive deficits. Conclusion. The severity of positive symptoms of schizophrenia was lower in patients with mild neurocognitive deficits. The most pronounced neurocognitive deficits are observed in patients receiving AAD.
Highlights
We examined 118 patients with schizophrenia, aged 34 [29; 41] years, and with a disease duration of 10 [4; 16] years. 33 patients (28%) received conventional antipsychotic drugs (CAD), and 85 (72%) patients received atypical antipsychotic drugs (AAD)
According to the subscale of positive Positive and Negative Syndrome Scale (PANSS) symptoms, patients with mild neurocognitive deficits had a lower average total score compared to patients with severe neurocognitive deficits (p = 0.011), who, in turn, received significantly longer antipsychotic therapy compared with patients with moderate (p = 0.014) and mild (p = 0.01) neurocognitive deficits
The duration of CAD treatment did not differ between clusters; the obtained results on antipsychotics as a whole were obtained due to AAD (p = 0.005 and p = 0.001, respectively)
Summary
Оценить связь клинических и терапевтических показателей с выраженностью нейрокогнитивного дефицита у пациентов с шизофренией. Конвенциональные антипсихотические препараты (КАП) получали 33 пациента (28%), атипичные антипсихотическое препараты (ААП) – 85 (72%) пациентов. Оценка когнитивных функций проведена всем пациентам по шкале краткой оценки когнитивных функций у пациентов с шизофренией (Brief Assessment of Cognition in Schizophrenia, BACS), клинико-психопатологической симптоматики – с использованием шкалы позитивных и негативных синдромов (Positive and Negative Syndrome Scale, PANSS). При этом длительность приема КАП не различалась между кластерами, следовательно, имеющиеся результаты по антипсихотикам в целом получены за счет ААП (p = 0,005 и p = 0,001 соответственно). Тригексифенидил не оказал влияния на выраженность нейрокогнитивного дефицита. Выраженность позитивных симптомов шизофрении была ниже у пациентов с легким нейрокогнитивным дефицитом. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи
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