精神分裂症患者的认知功能障碍探讨
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摘要
目的探讨精神分裂症患者的认知功能障碍。方法选取首都医科大学附属北京安定医院北京重大疾病临床数据和样本资源库-精神疾病库88例精神分裂症患者为病例组,120例正常人为对照组,比较两组受试者词语流畅性测试(VFT)结果。病例组按病情严重程度分为阳性与阴性症状量表(PANSS)<70分组44例、PANSS≥70分组44例,比较两个亚组VFT结果。结果病例组VFT各类别词语数量及总数均低于对照组,差异均有统计学意义(均P<0.05)。病例组PANSS≥70分组VFT各类别词语数量及总数均低于PANSS<70分组,差异均有统计学意义(均P<0.05)。结论精神分裂症患者存在认知功能障碍,且与疾病严重程度有关。
Objective To assess the cognitive function in patients with schizophrenia. Methods Eighty-eight schizophrenic patients and 120 normal subjects were selected as case group and control group from Beijing Biobank for Mental disorders of Beijing Anding Hospital Affiliated to Capital Medical University. The results of verbal fluency test(VFT) were compared between the two groups. According to the severity of disease,the patients were divided into PANSS(positive and negative symptoms scale) <70 group(n=44) and PANSS≥70 group(n=44). The VFT results of the two subgroups were compared. Results The total number of words and all category numbers of words in VFT of case group were significantly lower than those in the control group(all P<0.05). The total number of words and all category numbers of words in VFT of PANSS≥70 group were significantly lower than those in PANSS<70 group(all P<0.05). Conclusion Cognitive dysfunction exists in patients with schizophrenia and is related to the severity of the disease.
Objective To assess the cognitive function in patients with schizophrenia. Methods Eighty-eight schizophrenic patients and 120 normal subjects were selected as case group and control group from Beijing Biobank for Mental disorders of Beijing Anding Hospital Affiliated to Capital Medical University. The results of verbal fluency test(VFT) were compared between the two groups. According to the severity of disease,the patients were divided into PANSS(positive and negative symptoms scale) <70 group(n=44) and PANSS≥70 group(n=44). The VFT results of the two subgroups were compared. Results The total number of words and all category numbers of words in VFT of case group were significantly lower than those in the control group(all P<0.05). The total number of words and all category numbers of words in VFT of PANSS≥70 group were significantly lower than those in PANSS<70 group(all P<0.05). Conclusion Cognitive dysfunction exists in patients with schizophrenia and is related to the severity of the disease.
引文
[1]Bora E,Y cel M,Pantelis C.Cognitive impairment in schizophrenia and affective psychoses:implications for DSM-5 criteria and beyond[J].Schizophr Bull,2010,36(1):36-42.DOI:10.1093/schbul/sbp094.
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[11]陈诚,王惠玲,王高华,等.精神分裂症患者认知功能损害的相关研究[J].神经疾病与精神卫生,2015,15(2):112-114.DOI:10.3969/j.issn.1009-6574.2015.02.002.
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[13]Knowles EE,Weiser M,David AS,et al.The puzzle of processing speed,memory,and executive function impairments in schizophrenia:fitting the pieces together[J].Biological Psychiatry,2015,78(11):786-793.DOI:10.1016/j.biopsych.2015.01.018.
[14]Wright B,Peters E,Ettinger U,et al.Effects of environmental noise on cognitive(dys)functions in schizophrenia:a pilot within-subjects experimental study[J].Schizophr Res,2016,173(1-2):101-108.DOI:10.1016/j.schres.2016.03.017.
[15]Talreja BT,Shah S,Kataria L.Cognitive function in schizophrenia and its association with socio-demographics factors[J].Ind Psychiatry J,2013,22(1):47-53.DOI:10.4103/0972-6748.123619.
[16]Li HJ,Xu Y,Zhang KR,et al.Homotopic connectivity in drugnaive,first-episode,early-onset schizophrenia[J].J Child Psychol Psychiatry,2015,56(4):432-443.DOI:10.1111/jcpp.12307.
[17]Kalwa A,Rzewuska M,Borkowska A.Cognitive dysfunction progression in schizophrenia-Relation to functional and clinical outcome[J].Arch Psychiatry Psychother,2012,24(1):5-13.
[18]Laere E,Tee SF,Tang PY.Assessment of Cognition in Schizophrenia Using Trail Making Test:A Meta-Analysis[J].Psychiatry Investig,2018,15(10):945-955.DOI:10.30773/pi.2018.07.22.
[19]Bora E,Pantelis C.Meta-analysis of cognitive impairment in first-episode bipolar disorder:comparison with first-episode schizophrenia and healthy controls[J].Schizophr Bull,2015,41(5):1095-1104.DOI:10.1093/schbul/sbu198.
[20]Fioravanti M,Bianchi V,Cinti ME.Cognitive deficits in schizophrenia:an updated metanalysis of the scientific evidence[J].BMC Psychiatry,2012,12(1):1-20.DOI:10.1186/1471-244X-12-64.
[21]Fatouros-Bergman H,Cervenka S,Flyckt L,et al.Meta-analysis of cognitive performance in drug-na1ve patients with schizophre nia[J].Schizophr Res,2014,158(1-3):156-162.DOI:10.1016/j.schres.2014.06.034.
[22]周晨辉,王志仁,刘小蕾,等.精神分裂症患者认知功能损害的机制及治疗进展[J].国际精神病学杂志,2017,44(2):204-206.DOI:10.13479/j.cnki.jip.2017.02.003.
[23]Meier MH,Caspi A,Reichenberg A,et al.Neuropsychological decline in schizophrenia from the premorbid to the postonset period:evidence from a population-representative longitudinal study[J].The American Journal of Psychiatry,2014,171(1):91-101.DOI:10.1176/appi.ajp.2013.12111438.
[24]Seidman LJ,Giuliano AJ,Meyer EC,et al.Neuropsychology of the prodrome to psychosis in the NAPLS consortium:relationship to family history and conversion to psychosis[J].Archives of General Psychiatry,2010,67(6):578-588.DOI:10.1001/archgenpsychiatry.2010.66.
[25]Seidman LJ,Cherkerzian S,Goldstein JM,et al.Neuropsychological performance and family history in children at age 7 who develop adult schizophrenia or bipolar psychosis in the New England Family Studies[J].Psychological Medicine,2013,43(1):119-131.DOI:10.1017/s0033291712000773.
[26]Nielsen RE,Levander S,Kjaersdam TG,et al.Second generation antipsychotic effect on cognition in patients with schizophrenia-a meta-analysis of randomized clinical trials[J].Acta Psychiatrica Scandinavica,2015,131(3):185-196.DOI:10.1111/acps.12374.
[2]Sheffield JM,Karcher NR,Barch DM.Cognitive Deficits in Psychotic Disorders:A Lifespan Perspective[J].Neuropsychol Rev,2018,10(7):186-211.DOI:10.1007/s11065-018-9388-2.
[3]Trotta A,Murray RM,Mac Cabe JH.Do premorbid and post-onset cognitive functioning differ between schizophrenia and bipolar disorder?A systematic review and meta-analysis[J].Psychological Medicine,2015,45(2):381-394.DOI:10.1017/s0033291714001512.
[4]Kern RS,Gold JM,Dickinson D,et al.The MCCB impairment profile for schizophrenia outpatients:results from the MATRICS psychometric and standardization study[J].Schizophrenia Research,2011,126(1-3):124-131.DOI:10.1016/j.schres.2010.11.008.
[5]Mac Cabe JH,Wicks S,Lofving S,et al.Decline in cognitive performance between ages 13 and 18 years and the risk for psychosis in adulthood:a Swedish longitudinal cohort study in males[J].JAMA Psychiatry,2013,70(3):261-270.DOI:10.1001/2013.jamapsychiatry.43.
[6]Meier MH,Caspi A,Reichenberg A,et al.Neuropsychological decline in schizophrenia from the premorbid to the postonset period:evidence from a population-representative longitudinal study[J].The American Journal of Psychiatry,2014,171(1):91-101.DOI:10.1176/appi.ajp.2013.12111438.
[7]Rapoport JL,Giedd JN,Gogtay N.Neurodevelopmental model of schizophrenia:update 2012[J].Molecular Psychiatry,2012,17(12):1228-1238.DOI:10.1038/mp.2012.23.
[8]陈哨,张云淑,栗克清.精神分裂症患者认知功能评估方法的研究进展[J].中国健康心理学杂志,2017,25(3):461-467.DOI:10.13342/j.cnki.cjhp.2017.03.039.
[9]Osborne AL,Solowij N,Weston-Green K.A Systematic review of the effect of cannabidiol on cognitive function:relevance to schizophrenia[J].Neurosci Biobehav Rev,2017,72:310-324.DOI:10.1016/j.neubiorev.2016.11.012.
[10]Pena J,Ibarretxe-Bilbao N,S nchez P,et al.Mechanisms of functional improvement through cognitive rehabilitation in schizophrenia[J].Psychiatr Res,2018,101(10):21-27.DOI:10.1016/j.jpsychires.2018.03.002.
[11]陈诚,王惠玲,王高华,等.精神分裂症患者认知功能损害的相关研究[J].神经疾病与精神卫生,2015,15(2):112-114.DOI:10.3969/j.issn.1009-6574.2015.02.002.
[12]Bowie CR,Harvey PD.Cognitive deficits and functional outcome in schizophrenia[J].Neuropsychiatr Dis Treat,2006,2:531-536.DOI:10.2147/nedt.2006.2.4.531.
[13]Knowles EE,Weiser M,David AS,et al.The puzzle of processing speed,memory,and executive function impairments in schizophrenia:fitting the pieces together[J].Biological Psychiatry,2015,78(11):786-793.DOI:10.1016/j.biopsych.2015.01.018.
[14]Wright B,Peters E,Ettinger U,et al.Effects of environmental noise on cognitive(dys)functions in schizophrenia:a pilot within-subjects experimental study[J].Schizophr Res,2016,173(1-2):101-108.DOI:10.1016/j.schres.2016.03.017.
[15]Talreja BT,Shah S,Kataria L.Cognitive function in schizophrenia and its association with socio-demographics factors[J].Ind Psychiatry J,2013,22(1):47-53.DOI:10.4103/0972-6748.123619.
[16]Li HJ,Xu Y,Zhang KR,et al.Homotopic connectivity in drugnaive,first-episode,early-onset schizophrenia[J].J Child Psychol Psychiatry,2015,56(4):432-443.DOI:10.1111/jcpp.12307.
[17]Kalwa A,Rzewuska M,Borkowska A.Cognitive dysfunction progression in schizophrenia-Relation to functional and clinical outcome[J].Arch Psychiatry Psychother,2012,24(1):5-13.
[18]Laere E,Tee SF,Tang PY.Assessment of Cognition in Schizophrenia Using Trail Making Test:A Meta-Analysis[J].Psychiatry Investig,2018,15(10):945-955.DOI:10.30773/pi.2018.07.22.
[19]Bora E,Pantelis C.Meta-analysis of cognitive impairment in first-episode bipolar disorder:comparison with first-episode schizophrenia and healthy controls[J].Schizophr Bull,2015,41(5):1095-1104.DOI:10.1093/schbul/sbu198.
[20]Fioravanti M,Bianchi V,Cinti ME.Cognitive deficits in schizophrenia:an updated metanalysis of the scientific evidence[J].BMC Psychiatry,2012,12(1):1-20.DOI:10.1186/1471-244X-12-64.
[21]Fatouros-Bergman H,Cervenka S,Flyckt L,et al.Meta-analysis of cognitive performance in drug-na1ve patients with schizophre nia[J].Schizophr Res,2014,158(1-3):156-162.DOI:10.1016/j.schres.2014.06.034.
[22]周晨辉,王志仁,刘小蕾,等.精神分裂症患者认知功能损害的机制及治疗进展[J].国际精神病学杂志,2017,44(2):204-206.DOI:10.13479/j.cnki.jip.2017.02.003.
[23]Meier MH,Caspi A,Reichenberg A,et al.Neuropsychological decline in schizophrenia from the premorbid to the postonset period:evidence from a population-representative longitudinal study[J].The American Journal of Psychiatry,2014,171(1):91-101.DOI:10.1176/appi.ajp.2013.12111438.
[24]Seidman LJ,Giuliano AJ,Meyer EC,et al.Neuropsychology of the prodrome to psychosis in the NAPLS consortium:relationship to family history and conversion to psychosis[J].Archives of General Psychiatry,2010,67(6):578-588.DOI:10.1001/archgenpsychiatry.2010.66.
[25]Seidman LJ,Cherkerzian S,Goldstein JM,et al.Neuropsychological performance and family history in children at age 7 who develop adult schizophrenia or bipolar psychosis in the New England Family Studies[J].Psychological Medicine,2013,43(1):119-131.DOI:10.1017/s0033291712000773.
[26]Nielsen RE,Levander S,Kjaersdam TG,et al.Second generation antipsychotic effect on cognition in patients with schizophrenia-a meta-analysis of randomized clinical trials[J].Acta Psychiatrica Scandinavica,2015,131(3):185-196.DOI:10.1111/acps.12374.