OBJECTIVE Schizophrenia is associated with a marked cognitive impairment that is widely believed to remain stable after illness onset. Yet, to date, 10-year prospective studies of cognitive functioning following the first episode with good methodology are rare. The authors examined whether schizophrenia patients experience cognitive decline after the first episode, whether this decline is generalized or confined to individual neuropsychological functions, and whether decline is specific to schizophrenia. METHODS Participants were from a population-based case-control study of patients with first-episode psychosis who were followed prospectively up to 10 years after first admission. A neuropsychological battery was administered at index presentation and at follow-up to patients with a diagnosis of schizophrenia (N=65) or other psychoses (N=41) as well as to healthy comparison subjects (N=103). RESULTS The schizophrenia group exhibited declines in IQ and in measures of verbal knowledge and of memory, but not processing speed or executive functions. Processing speed and executive function impairments were already present at the first episode and remained stable thereafter. The magnitude of declines ranged between 0.28 and 0.66 standard deviations. Decline in measures of memory was not specific to schizophrenia and was also apparent in the group of patients with other psychoses. Healthy individuals with low IQ showed no evidence of decline, suggesting that a decline is specific to psychosis. CONCLUSIONS Patients with schizophrenia and other psychoses experience cognitive decline after illness onset, but the magnitude of decline varies across cognitive functions. Distinct mechanisms consequent to the illness and/or psychosocial factors may underlie impairments across different cognitive functions.

中文翻译：

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第一集后十年内精神分裂症和其他精神病的认知变化。

目标精神分裂症与明显的认知障碍有关，人们普遍认为这种障碍在疾病发作后保持稳定。然而，迄今为止，在第一集之后使用良好方法对认知功能进行 10 年前瞻性研究的情况很少见。作者检查了精神分裂症患者在第一次发作后是否会出现认知能力下降，这种下降是普遍的还是仅限于个体神经心理功能，以及下降是否是精神分裂症特有的。方法 参与者来自一项以人群为基础的病例对照研究，该研究对首次入院后长达 10 年的首发精神病患者进行了前瞻性随访。对诊断为精神分裂症（N=65）或其他精神病（N=41）以及健康对照受试者（N=103）的患者进行指数介绍和随访时，进行了神经心理学电池组。结果 精神分裂症组表现出智商下降、言语知识和记忆测量下降，但处理速度或执行功能没有下降。处理速度和执行功能障碍在第一集中已经出现，此后保持稳定。下降幅度在 0.28 到 0.66 个标准差之间。记忆力的下降并不是精神分裂症特有的，在其他精神病患者组中也很明显。智商低的健康个体没有表现出下降的迹象，这表明下降是精神病特有的。结论 精神分裂症和其他精神病患者在发病后会出现认知能力下降，但下降的幅度因认知功能而异。疾病和/或心理社会因素导致的不同机制可能是不同认知功能障碍的基础。