Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-27T06:28:50.943Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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