Resumen
La esquizofrenia genera un deficit neuropsicologico relacionado con funciones frontales, pero en la actualidad no existen baterías capaces de discriminar los diferentes patrones de afectación neuropsicologica. Debido a esto, desarrollamos una batería neuropsicologica que involucra las afectaciones cognitivas más comunes en cada subtipo clínico de la esquizofrenia. Para su validación, se determinó la consistencia interna de la batería mediante el coeficiente alfa de Cronbach. Los resultados de la batería fueron correlacionados con la MCCB (MATRICS Consensus Cognitive Battery) y BACS (Brief Assessment of Cognition in Schizophrenia). La habilidad de la batería para discriminar entre controles y pacientes con esquizofrenia fue determinada mediante la curva ROC (Receiver Operating Characteristic). La consistencia interna fue de 0,868 y la mayoría de los test de la batería correlacionan significativamente entre ellos. Nuestra batería no tuvo correlaciones con MCCB (p:0,937) y BACS (p:0,496). La curva ROC generó un punto de corte entre controls y esquizofrénicos de 17 puntos, con una sensibilidad de 96,6% y especificidad de 95,0%. El área bajo la curva ROC fue 0,990 (CI: 95%; 0,490; p < 0.0001). Además, nuestra batería puso en evidencia propiedades de agrupación para cada subtipo clínico de la esquizofrenia. En conclusión, nuestra batería es capaz de identificar diferentes patrones de afectación neuropsicológica en todos los subtipos clínicos de la enfermedad.
Abstract
Schizophrenia generates neuropsychological deficit related to prefrontal functions, but there no existent batteries capable to identify different patterns of neuropsychological affectation. Therefore, we developed a brief neuropsychology battery which encompasses the most frequent cognitive deficits in every clinical subtype of the disease. In line with this, an internal consistency of Schizophrenia´s Neuropsychological Screening (SNS) was determined with Cronbach’s alpha coefficient. The SNS total score was correlated with MATRICS Consensus Cognitive Battery (MCCB) and with Brief Assessment of Cognition in Schizophrenia (BACS). The ability of the SNS to discriminate neuropsychological profile of healthy controls from patients diagnosed with schizophrenia was determined using a receiver operating characteristic (ROC) curve analysis. The results of this study showed that Internal consistency of the SNS (Cronbach’s alpha) was 0.868, and most subtests correlated significantly between themselves. SNS did not correlate with classic neuropsychological batteries for schizophrenia MCCB (p:0,937) neither with BACS (p:0,496). The ROC curve analysis on the SNS total score between healthy controls and schizophrenic patients generated a cutoff score of 17 points with a sensitivity of 96.6% and specificity of 95.0%. Area under the ROC curve was 0.990 (CI: 95%; 0,490; p < 0.0001). Moreover, the SNS showed neuropsychological clustering properties for every clinical subtype of schizophrenia. In conclusion, SNS is a new kind of neuropsychological battery which is capable of identifying specific patterns of neuropsychological affectation in all the clinical presentations of schizophrenia.
Keywords: Catatonia; biological psychiatry; hebephrenia; paranoid delusion; prefrontal cortex; endophenotype.
Citas
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