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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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