Avaliação neuropsicológica na esquizofrenia: revisão sistemática: [revisão]

O presente artigo tem como objetivo sintetizar estudos sobre os testes neuropsicologicos que estao sendo mais utilizados em esquizofrenia. Foi realizada uma revisao sistematica da literatura, consultando-se: PubMed, MEDLINE (via PubMed) e LILACS, no periodo entre 1995 e 2006. As palavras-chave foram: cognition and schizophrenia; evaluation and cognition and schizophrenia; functioning and cognition and schizophrenia. Foi feita uma pesquisa manual de referencias dos artigos mais citados, incluindo estudos de metanalise, revisao teorica e da Measurement and Treatment Research to Improve Cognition in Schizophrenia. Criterios de inclusao: estudos com pacientes com esquizofrenia que mencionaram a utilizacao de testes neuropsicologicos. Foi feita uma revisao sobre os testes mais citados, para verificacao de nomenclatura, indicacoes e quais estavam validados para o Brasil. Foram identificados 98 estudos: 77 empiricos, oito metanalises, seis revisoes teoricas e sete da Measurement and Treatment Research to Improve Cognition in Schizophrenia. Foram encontrados 102 diferentes nomes de testes neuropsicologicos, com citacao de 10 baterias de testes, na maioria compostas por subtestes ja padronizados. Entre os 77 estudos empiricos, 22 (28,57%) foram sobre validacao de instrumentos ou baterias de testes. Entre os 10 testes mais citados, apenas tres possuem validacao para o Brasil (WCST; Wechsler Adult Intelligence Scale; Mini-Mental Status Examination). Esses achados evidenciam uma ampla heterogeneidade nos criterios de selecao dos testes neuropsicologicos, divergencias na nomenclatura e certa tendencia para a criacao de novos testes e baterias para avaliacao de funcoes cognitivas. A relevância e caracteristicas dos prejuizos cognitivos na esquizofrenia revelam a urgente necessidade de identificacao especifica e padronizada de metodos de avaliacao neuropsicologica para pacientes brasileiros. This article aims at summarizing studies on the most commonly used neuropsychological tests in schizophrenia. A systematic literature review was performed on PubMed, MEDLINE (via PubMed) and LILACS, from 1995 through 2006. The keywords were cognition and schizophrenia; evaluation and cognition and schizophrenia; functioning and cognition and schizophrenia. A manual research of references in most frequently cited articles was performed, including meta-analysis studies, theoretical reviews, and the Measurement and Treatment Research to Improve Cognition in Schizophrenia. Inclusion criteria were studies on schizophrenia patients that reported use of neuropsychological tests. A review of the most frequently cited tests was performed to check nomenclature, indications, and which were validated for Brazil. A total of 98 studies were identified: 77 empirical studies, eight meta-analyses, six theoretical reviews and seven from the Measurement and Treatment Research to Improve Cognition in Schizophrenia. There were 102 different names of neuropsychological tests; 10 batteries of tests were cited, most of them composed by previously standardized subtests. Of the 77 empirical studies, 22 (28.57%) were about validation of instruments or batteries of tests. Of the 10 most frequently cited tests, only three had been validated for Brazil (WCST; Wechsler Adult Intelligence Scale; Mini-Mental Status Examination). These findings show a wide heterogeneity in the selection criteria of neuropsychological tests, disagreement as to the nomenclature, and a certain trend toward creation of new tests and batteries for evaluating cognitive functions. The relevance and characteristics of cognitive impairments in schizophrenia confirm the urgent necessity of specific and standardized identification of neuropsychological evaluation methods for Brazilian patients.