Neuropsychological differences between treatment-resistant and treatment-responsive schizophrenia: a meta-analysis
Autor: | Eugenia Kravariti, Robin M. Murray, Olga Hide, James H. MacCabe, Stephen M. Lawrie, Edward Millgate |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
language functions
verbal memory and learning business.industry Schizophrenia (object-oriented programming) Neuropsychology Review Article Neuropsychological Tests Psychotic Disorders/psychology meta-analysis Psychiatry and Mental health Schizophrenia/drug therapy Memory Short-Term Psychotic Disorders Meta-analysis Schizophrenia Medicine Humans business Treatment resistant Applied Psychology Antipsychotic Agents/therapeutic use treatment-resistant schizophrenia Clinical psychology Antipsychotic Agents neuropsychological deficits |
Zdroj: | Psychological Medicine Millgate, E, Hide, O, Lawrie, S M, Murray, R M, MacCabe, J H & Kravariti, E 2021, ' Neuropsychological differences between treatment-resistant and treatment-responsive schizophrenia : a meta-analysis ', Psychological Medicine, vol. 52, no. 1, pp. 1-13 . https://doi.org/10.1017/S0033291721004128 |
ISSN: | 1469-8978 0033-2917 |
Popis: | Antipsychotic treatment resistance affects up to a third of individuals with schizophrenia. Of those affected, 70–84% are reported to be treatment resistant from the outset. This raises the possibility that the neurobiological mechanisms of treatment resistance emerge before the onset of psychosis and have a neurodevelopmental origin. Neuropsychological investigations can offer important insights into the nature, origin and pathophysiology of treatment-resistant schizophrenia (TRS), but methodological limitations in a still emergent field of research have obscured the neuropsychological discriminability of TRS. We report on the first systematic review and meta-analysis to investigate neuropsychological differences between TRS patients and treatment-responsive controls across 17 published studies (1864 participants). Five meta-analyses were performed in relation to (1) executive function, (2) general cognitive function, (3) attention, working memory and processing speed, (4) verbal memory and learning, and (5) visual−spatial memory and learning. Small-to-moderate effect sizes emerged for all domains. Similarly to previous comparisons between unselected, drug-naïve and first-episode schizophrenia samples v. healthy controls in the literature, the largest effect size was observed in verbal memory and learning [dl = −0.53; 95% confidence interval (CI) −0.29 to −0.76; z = 4.42; p < 0.001]. A sub-analysis of language-related functions, extracted from across the primary domains, yielded a comparable effect size (dl = −0.53, 95% CI −0.82 to −0.23; z = 3.45; p < 0.001). Manipulating our sampling strategy to include or exclude samples selected for clozapine response did not affect the pattern of findings. Our findings are discussed in relation to possible aetiological contributions to TRS. |
Databáze: | OpenAIRE |
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