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Factores cognitivos que discriminan entre pacientes esquizofrénicos con y sin respuesta al tratamiento

Published online by Cambridge University Press:  12 May 2020

E. Stip ,
I. Lussier ,
E. Ngan ,
A. Mendrek  and
P. Liddle
E. Stip
Affiliation:
Centro de investigación Fernand Seguin, Hospital L H. Lafontaine, Universidad de Montréal Departamento de Psiquiatría, Universidad Británica de Columbia, Vancouver, Canadá
I. Lussier
Affiliation:
Centro de investigación Fernand Seguin, Hospital L H. Lafontaine, Universidad de Montréal
E. Ngan
Affiliation:
Departamento de Psiquiatría, Universidad Británica de Columbia, Vancouver, Canadá
A. Mendrek
Affiliation:
Departamento de Psiquiatría, Universidad Británica de Columbia, Vancouver, Canadá
P. Liddle
Affiliation:
Departamento de Psiquiatría, Universidad Británica de Columbia, Vancouver, Canadá
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Resumen

Identificar qué mejoras en la función cognitiva se asocian con la resolución de los síntomas en pacientes esquizofrénicos tratados con antipsicóticos atípicos. Diseño: un ensayo abierto prospectivo con neuroléptics atípicos (risperidona, clozapina, quetiapina). Entorno: Unidades de pacientes hospitalizados y ambulatorios. Pacientes: Se incluyeron 39 pacientes con esquizofrenia según los criterios del DSM-IV. La evaluación clínica y cognitiva se hizo en la línea de base (T0) y de nuevo después de seis meses de tratamiento (T2). Veinticinco pacientes completaron el ensayo. Intervenciones: Antipsicóticos de nueva generación durante seis meses. Se consideraba que los pacientes respondían si su puntuación de la PANSS disminuía el 20% al menos (n = 15), y que no respondían si no lo hacía (n = 10). Medidas de evolución: una evaluación cognitiva informatizada comprendía pruebas de memoria a corto plazo (amplitud de dígitos), memoria explícita a largo plazo explícita (aprendizaje de pares de palabras), atención dividida, atención selectiva y fluidez verbal (ortográfica y semántica). La evaluación clínica incluía la PANSS y la ESRS. Resultados: Se realizó un análisis de función discriminante para determinar qué cambios en el rendimiento cognitivo predecían la condición de respuesta de los síntomas. La fluidez semántica y la fluidez ortográfica fueron predictores significativos. Juntos, predecían correctamente la condición de respuesta en el 88% de los casos. La memoria no fue un predictor significativo de la respuesta de los síntomas. Conclusión: la fluidez verbal discriminó al grupo de pacientes con respuesta del grupo de los pacientes sin ella durante un tratamiento farmacológico.

Keywords

antipsicóticoclozapinacogniciónquetiapinapaciente con respuesta al tratamientorispe-ridonaesquizofreniafluidez verbal
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 7 , Issue 4 , May 2000 , pp. 257 - 268
Copyright
Copyright © European Psychiatric Association 2000

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References

Bibliografía

Allen, HAFrith, CDSelective retrieval and free emission of cateeory examplars in schizophrenia. Br T Psychol 1983; 74: 481–90.CrossRefGoogle Scholar
Alien, HALiddle, PFFrith, CDNegative features, retrieval processes and verbal fluency in schizophrenia. Br J Psychiatry 1993; 163: 769–75.CrossRefGoogle Scholar
Arvanitis, LAMüller, BGSeroquel Trial 13 Study Group. Multiple fixed doses of ‘Seroquel’ (Quetiapine) in patients with acure exacerbation of schizophrenia: a comparison with haloperidol and placebo. Biol Psychiatry 1997; 42: 233–46.CrossRefGoogle Scholar
Azorin, JMRemington, GPere, JJBourdeix, IComparison with haloperidol and placebo. Biol Psychiatry 1997; 42: 233–46.Google Scholar
Bellack, ASGold, JMBuchanan, RWCognitive rehabilitation for schizophrenia: problems, prospects, and strategies. Schizphr Bull 1999; 25: 257–74.CrossRefGoogle ScholarPubMed
Breier, AMalhotra, ATung-Ping, SUPinals, DElman, IAdler, Cet al.Clozapine and risperidone in chronic schizophrenia: effects on symptoms, Parkinsonian side effects and neuroendocrine response. Am J Psy 1999; 156: 294–8.Google ScholarPubMed
Bub, DGum, TPsychlab software. McGill University. 1987.Google Scholar
Butters, NWolfe, JGranholm, EMartone, MAn assessment of verbal recall, recognition and fluency abilities in patients with Huntington’s disease. Cortex 1986; 22: 11–32.CrossRefGoogle ScholarPubMed
Chatelois, JPineau, HBelleville, SPeretz, ILussier, IFontaine, Fet al.Batterie informatisée d’évaluation de la mémoire inspirée de l’approche cognitive. Rev Can Psychol 1993; 34: 44–63.Google Scholar
Chouinard, GRoss-Chouinard, AAnnable, LJones, BDExtrapyramidal Symptom Rating Scale. Can J Neurol Sci 1980; 7: 233.Google Scholar
Crawford, JRObonsawin, MCBremmer, MFrontal lobe impairment in schizophrenia: relationship to intellectual function. Psychol Med 1993; 23: 787–90.CrossRefGoogle Scholar
Crow, TJThe molecular pathology of schizophrenia. BMJ 1980; 280: 66–8.CrossRefGoogle ScholarPubMed
Frith, CDThe cognitive neuropsychology of schizophrenia. Hove, UK: Lawrence Erlbaum; 1992.Google Scholar
Frith, CDAlien, HALanguaje disorders in schizophrenia and their implications for neuropsychology. In: Beddington, PMcguffin, P eds. Schizophrenia: the major issues. Oxford: Heinemann Medical; 1988.Google Scholar
Goldberg, TAloia, MGourovitch, MMissar, DPickard, DWeinberger, DCognitive substrates of thought disorder. I: The Semantic System. Am J Psychiatry 1998; 155: 1671–6.CrossRefGoogle ScholarPubMed
Goldberg, TEGreenberg, RDGriffin, SJGold, JMKleinman, JEPickard, Det al.The effect of clozapine on cognition and psychiatric symptoms in patients with schizophrenia. Br J Psychiatry 1993; 162: 43–8.CrossRefGoogle ScholarPubMed
Green, MFWalker, ENeuropsychological performance and positive and negative symptoms of schizophrenia. J Abnorm Psychol 1985; 94: 460–9.CrossRefGoogle ScholarPubMed
Green, MFWhat are the functional consequences of neurocognitive deficits in schizophrenia. Am J Psychiatry 1996; 153: 321–30.Google Scholar
Green, MFNuechterlein, KHShould schizophrenia be treated as a neurocognitive disorder? Schizophr Bull 1999; 25: 309–18.CrossRefGoogle ScholarPubMed
Gruzelier, JSeymour, KWilson, LJolley, AHirsch, SImpairments of neuropsychological tests of tempo-rohippocampol functions and word fluency in remiting schizophrenia and affective disorders. Arch Gen Psychiatry 1988; 45: 623–9.CrossRefGoogle Scholar
Gurd, JMWard, CDRetrieval from semantic and letter-initial categories in patients with Parkinson’s disease. Neuropsychologia 1989; 28: 737–41.Google Scholar
Hagger, CBuckley, PKenny, JTFreidman, LUbogy, DMeltzer, HYImprovement in cognitive functions and psychiatric symptoms in treatment-refractory schizophrenic patients receiving clozapine. Biol Psychiatry 1993; 34:702–12.CrossRefGoogle ScholarPubMed
Hodges, JRSalmon, DPButters, NDifferential impairment episodic and semantic memory in Alzheimer’s and Huntington’s disease: a control prospective study. J Neurol Neurosurg Psychiatry 1990; 53: 1089–95.CrossRefGoogle Scholar
Janowsky, JSShimamura, APKritchensky, MSquire, LRCognitive impairment following frontal lobe damage and its relevance to human amnesia. Behav Neurosci 1989; 103: 548–60.CrossRefGoogle ScholarPubMed
Joyce, EMCollinson, SLCrichton, PVerbal fluency in schizophrenia: relationship with executive function, semantic memory and clinical alogia. Psychol Med 1996; 26: 39–49.CrossRefGoogle ScholarPubMed
Kane, JHnigfeld, GSinger, JMeltzer, HClozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine. Arch Gen Psychiatry 1988; 45:789–96.CrossRefGoogle ScholarPubMed
Kay, SRFiszbein, AOpler, LAThe positive and negative syndrome scale. Schizophr Bull 1987; 13: 261–76.CrossRefGoogle ScholarPubMed
Keefe, RSilva, SGPerkins, DOLieberman, JAThe effects of atypical antipsychotic drugs on neurocognitive impairment in schizophrenia: A review and metaanalysis. Schizophr Bull 1999; 25: 201–22.CrossRefGoogle Scholar
Kolb, BWishaw, IQPerformance of schizophrenic patients on tests sensitive toleft or right frontal,temporal or parietal function in neurological patients. J Nerv Ment Dis 1983; 171: 435–43.CrossRefGoogle ScholarPubMed
Liddle, PFSchizophrenic syndromes, cognitive performance and neurological dysfunction. Psychol Med 1987; 17: 49–57.CrossRefGoogle ScholarPubMed
Martin, AFedio, PWord production and comprehension in Alzheimer’s disease: the break down of semantic knowledge. Brain Lang 1983; 19: 124–41.CrossRefGoogle Scholar
Martin, RCLoring, DWMeador, KJLee, GPThe effects of lateralized temporal lobe dysfucntion on frontal and semantic fluency. iNeuropsychologia 1990; 28: 823–9.CrossRefGoogle Scholar
Meltzer, HUtilization, multidimensional outcome measures, and risk-benefit considerations for the use of clozapine in schizophrenia. In: Brunelle, NMendlewicz, JRacagni, G eds. New Generation of Antipsychotic Drugs: Novel mechanisms of action. Vol. 4. Basel: Karger; 1993. p. 103–17.Google Scholar
Milner, BSome effects of frontal lobectomy in man. In: Warren, JMAkert, K eds. The Frontal Granular Cortex and Behaviour. New York: McGraw-Hill; 1964. p. 313–44.Google Scholar
Norman, RMalla, ACortese, LCheng, SDiaz, KMclntosh, Eet al.Symptoms and cognition as predictors of community functioning: a prospective analysis. Am J Psychiatry 1999; 156: 400–5.Google ScholarPubMed
Overall, JEGorham, DRBrief Psychiatric Rating Scale. Psychol Rep 1962; 10: 799–812.CrossRefGoogle Scholar
Pasquier, FLebert, FGrymonprez, LPetit, HVerbal fluency in dementia of frontal lobe type and dementia of Alzheimer type. J Neurol Neurosurg Psychiatry 1995; 58:81–4.CrossRefGoogle ScholarPubMed