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Déficit atencionales y respuesta al tratamiento farmacológico en pacientes con esquizofrenia resistente al tratamiento: Resultados mediante análisis factorial confirmatorio

2010; Elsevier BV; Volume: 3; Issue: 2 Linguagem: Inglês

10.1016/j.rpsm.2010.02.001

1989-4600

Pedro Sánchez, Natalia Ojeda, Edorta Elizagárate, Javier Peña, Javier Ballesteros, Ana B. Yoller, Miguel Gutiérrez, Leonardo Casais, Jesús Ezcurra,

Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes

There are no experimental data that demonstrate whether patients with neuroleptic-resistant schizophrenia differ or not in their pattern of neuropsychological functioning from patients with adequate drug response.Fifty-two patients with drug-resistant psychosis (DRP) and 42 patients with schizophrenia not resistant to treatment (NDRP) were recruited following the criteria of Kane et al (1988). A sample of 45 healthy controls matched by age, sex and educational level was also recruited. The clinical evaluations used were the Positive and Negative Symptom Scale (PANSS), functional disability (WHO-DAS) and the Clinical Global Impression (CGI) scale.Through the use of confirmatory factor analysis, we obtained a latent cognitive structure of six cognitive factors: attention, processing speed, verbal memory, working memory, verbal fluency and executive functions. As expected, the control group performed better than the two patient groups (both DRP and NDRP) in all neuropsychological domains. Additionally, the DRP group scored significantly worse in attention than the NDRP group even though no differences between these two groups were found in age of disease onset, number of hospitalizations or length of hospitalization. From a clinical point of view, the DRP group showed greater severity of positive symptoms (p<0.01) and higher global deterioration (p<0.01), which did not translate into greater functional disability.The results obtained do not allow us to conclude that there is a specific neuropsychological profile in neuroleptic-resistant patients. The only differential parameter was performance in the attentional domain. Our findings better fit the hypothesis of a «clinical continuum» and differ from the categoric classification of this mental disorder.