精神分裂症与双相情感障碍患者认知功能的比较

Comparison of Neurocognition Between Drug-Free Patients with Schizophrenia and Bipolar Disorder

【目的】精神分裂症和双相情感障碍都存在某些认知功能障碍,由于临床症状的重叠,这两类患者的鉴别较困难。本研究对两类疾病的认知功能障碍进行比较,探讨认知功能对临床鉴别诊断的价值。【方法】对30例阳性症状为主的精神分裂症患者、22例阴性症状为主的精神分裂症患者、27例双相情感障碍(躁狂状态)患者和28例正常对照者行相关认知心理试验(COGLAB)。【结果】COGLAB区别阴性精神分裂症和双相情感障碍的正确率达到了73.5%,其中分类测验、持续操作测验和倒行掩蔽测验判别作用最大。【结论】本研究的结果提示,阴性精神分裂症和双相障碍患者的认知作业反应的特征不同,威斯康星卡片分类、持续操作测验、倒行掩蔽测验对于临床上鉴别某些精神分裂症和双相情感障碍有一定参考意义。

[Objective]It is often difficult to make a differential diagnosis between schizophrenia and bipolar disorder because of the overlapping symptoms. The patients of both disorders have been shown to have neurocognitive deficits.[Methods]A computerized battery of neurocognitive tasks (called COGLAB) was administered to four participant groups: 30 patients with positive schizophrenia, 22 patients with negative schizophrenia, 27 patients with bipolar disorder, and 28 normal controls. All the patients were drug-free for at least one month. The tasks included Mueller-Lyer illusion, reaction time, size estimation, a variant of the Wisconsin Card Sorting Test, backward masking, and Asarnow continuous performance.[Results]Discriminant analyses were used to investigate the differences among the four groups. COGLAB correctly classified 73.5% of the cases of negative schizophrenia and bipolar disorder. The best discriminative tasks were card sort, Asarnow continuous performance and backward masking.[Conclusion]The patterns of neurocognitive task responses between patients with negative schizophrenia and those with bipolar disorder are different, and card sort, continuous performance test, and backward masking can be used to help the differential diagnosis between negative schizophrenia and bipolar disorder in clinical work.