首发偏执型精神分裂症患者执行功能研究

A study on the executive function of first episode paranoid schizophrenia

目的探讨偏执型精神分裂症患者执行功能障碍与精神症状、注意、记忆及预后的关系。方法对80例首次发病的偏执型精神分裂症患者采用威斯康星卡片分类测验(WCST)评估执行功能,数字划销测验(CT)评估注意功能,修订韦氏成人记忆量表(WMSRC)评估记忆功能,PANSS量表评估精神症状。分别将治疗前WCST成绩与精神症状、净分、失误率、记忆商做相关分析;将治疗前WCST成绩与治疗6周后精神症状的减分值做相关分析。结果WCST的总测验次数、持续错误数、随机错误数均与阴性症状评分呈显著正相关(r分别为0.299,0.398,0.31;P<0.01)。与数字划销测验的净分呈显著负相关(r分别为0.38,0.35,0.31;P<0.01),正确数、分类完成数均与净分呈显著正相关(r分别为0.23,0.26;P<0.05);总测验次数、随机错误数均与记忆商呈显著负相关(r分别为0.29,0.28;P<0.01或P<0.05),治疗前持续错误数与阴性症状的减分值呈显著负相关(r=-0.225,P<0.05)。结论偏执型精神分裂症执行功能障碍与阴性症状的严重程度及预后相联系,执行功能障碍可能是其他认知缺陷如注意、记忆及某些精神症状的产生机制。

Objective To assess the relationship of executive function with symptomatology and treatment outcome of first episode paranoid schizophrenia. Methods 80 cases of first episode paranoid schizophrenia were included, Executive function was measured with the Wisconsin Card Sorting Test, attention and memory function were measured with Cancellation Test （CT） and Wechsler Memory Scale, clinical status was assessed with Positive and Negative Syndrome Scale （PANSS）. Results On the WSCT, all the scores of total trials, perseverative errors, random errors were positively and significantly related to negative symptoms , at the same negatively and significantly related to the scores of net scale of cancellation, and the Memory Quotient, too ; after 6 weeks of antipsychotic medications, There was a significant negative correlation between the decreased scores of negative symptoms and the scores of perseverative errors which before treatment. Conclusions The executive dysfunction is related to the severity and prognosis of negative symptom in first episode paranoid schizophrenia ; May be the executive dysfunction give birth to the attention and memory impairment and some psychiatric symptoms.