| BackgroundSchizophrenia is one of the common diseases in psychological subjects,mainly for the negative symptoms,positive symptoms and cognitive disorders.Cognitive impairment affects attention,memory and other executive power or work which related to all the aspects of life,it has an enormous impact on individuals and their families,severely reducing the life quality of patients and their families,so the cognitive impairment therapy of the patients with first-episode schizophrenia is significant essential.As the second-generation antipsychotics olanzapine and aripiprazole have a better effect to control psychotic symptoms,if it also have a good effect in improving cognition in patients,it will be a major positive for the patients with first-episode schizophrenia.The study will be expanded to focus on this direction.Objectives1.Analysis and compared the improved of clinical efficacy and neurocognitive function in patients with first-episode schizophrenia.who have take aripiprazole or olanzapine.2.Analysis and discussion the situation of neurocognitive impairment between the patients with first-episode schizophrenia and the normals.3.To explore the possibility of P300 as a screening of cognitive impairment in patients with first-episode schizophrenia.Methods1 Eighty patients were randomly divided into two groups,clinical symptoms were assessed by the PANSS,neurocognitive function was examined by cognitive tests,including HVLT-R,BVMT-R,SSS,VF,SWT,SCT,SCWT,DSC and Event-related potential(ERP)P300 latency and amplitude at baseline and after treatment 6 months respectively.2 Thirty healthy persons as normal control group,they were only assessed baseline Event-related potential(ERP)P300 latency and amplitude and neurocognitive scale tests.Results1.The results of general information and the PANSS scale and neurocognitive scale.Thirty-five cases in aripiprazole group and thirty-six cases in olanzapine group completed trial.Compared with that of baseline,after 6 months treatment,two groups of PANSS positive symptoms,negative symptoms,general psychopathology scores and PANSS total scores were significantly lower(P<0.001),there was no significant difference between the two groups.Aripiprazole improved the HVLT-R,BVMT-R,SSS forward and backward,SWT and SWCT scores(all P<0.05);olanzapine improved BVMT-R,DSC,SCT and SWCT scores(all P < 0.05).At baseline,all cognitive performances in aripiprazole group were lower than that of the healthy control group(all P≤0.025);all cognitive performances in olanzapine group lower than that of the healthy control group but SSS forward performance.After 6 months treatment,except for BVMT-R,SSS forward and backward performances,the other cognitive performances of the two groups were all lower than that of the healthy control group.2.The result of Event-related potential(ERP)P300.1)P300 latency: Compared with the control group,the P300 latency of the aripiprazole group,olanzapine group were prolonged and the differences were statistically significant(P <0.01)before treatment and after six months of treatment,compared with the aripiprazole group,olanzapine group was prolonged and had a significant statistically difference(P <0.01).After six months of treatment,the P300 latency of aripiprazole group and olanzapine group were significantly shortened compared with untreatment,and the differences were statistically significant(P <0.01)2)P300 amplitude: Compared with the control group,the P300 amplitude of the aripiprazole group and olanzapine group were decreased,and the differences were statistically significant(P <0.01)before treatment and after six months of treatment,there is no statistically significant difference between the aripiprazole group and the olanzapine group(P>0.05).After six months of treatment,the P300 amplitude of the aripiprazole group and the olanzapine group were significantly elevated compared with untreatment,and the differences were statistically significant(P <0.01)3.Pearson Correlation Analysis: Between P300 latency and amplitude presented a negative correlation(r =-0.478,P = 0.000),Between cognitive impairment and P300 latency presented negative correlation(r =-0.189,P = 0.000).ConclusionsThe two drugs may both improve psychotic symptoms and neurocognitive function.But the neurocognitive performances of the patients with first-episode schizophrenia are still lower than that of healthy control group after treatment,but they have fairly clinical effect,and have their own characteristics and advantages,so neurocognitive impairment may be the core symptoms of schizophrenia,P300 can provide a reference for cognitive impairment of the patients with first-episode schizophrenia. |
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