简明精神分裂症认知评估测验的临床信效度

Reliability and Validity of Brief Assessment of Cognition in Schizophrenia

目的:对简明精神分裂症认知评估测验(Brief Assessment of Cognitionin Schizophrenia,BACS)中文版的临床信效度进行检验。方法:122名符合精神障碍诊断统计手册第四版(DSM-IV)诊断标准的住院精神分裂症患者(男性84例,女性38例),接受简明精神分裂症认知评估测验(BACS)、精神分裂症认知功能成套测验共识版(MCCB)、威斯康星卡片分类测验(WCST)、色词测验(STROOP)和瑞文推理测验(RAVEN),4周后重测BACS。结果:(1)BACS平均完成时间为28.2分钟。其7个分测验符号编码(SC)、数字序列(DS)、代币运动(TM)、言语记忆(VM)、语义流畅性(CF)、字词流畅性(WF)、伦敦塔(TL)中,出现"地板效应"(零分)的测验为TL(3.4%,8人次),出现"天花板效应"(满分)的测验为DS(0.85%,2人次),TM(1.72%,4人次)、TL(0.85%,2人次);(2)BACS中7个分测验的重测信度分别为0.85、0.73、0.66、0.64、0.83、0.64、0.58(P<0.01),总的重测信度为0.85(P<0.01);(3)除TL与CF之间的相关性无统计学意义外,其他各分测验之间及各分测验与BACS总分之间相关性均有统计学意义(r=0.23～0.66,P<0.01);(4)VM和TL的A、B版本之间差异无统计学意义(P>0.05);(5)BACS总分与MCCB、RAVEN、WCST的完成分类数、正确应答数、STROOP呈正相关(r=0.83,0.51,0.48,0.40,0.50;P<0.001);(6)采用探索性因子分析,共得到3个因子,分别为工作记忆和执行功能、语义流畅性、处理速度和运动能力,3个因子累积解释总方差的72.6%。结论:简明精神分裂症认知评估测验作为一个精神分裂症认知功能的测量工具,临床信效度较好,值得进一步修订和完善。

Objective： To explore the reliability and validity of the Chinese Version of Brief Assessment of Cognition in Schizophrenia （BACS） . Methods： A total of 122 patients with schizophrenia, including 84 males and 38 females, who met DSM-IV criteria, were recruited to complete the BACS, MATRICS Cognitive Consensus Battery （ MCCB）, Wisconsin Card Sorting Test （ WCST）, Stroop Color-Word Test （STROOP） and Raven Standard Progres- sive Matrix （RAVEN）, and they completed BACS 4 weeks later. Results： （ 1 ） The average completion duration of BACS was 28. 2 minutes. Among seven subtests of BACS, including symbol coding （ SC）, digital sequencing （ DS）, token motor task （ TM ）, verbal memory （ VM ）, category fluency （ CF ）, word fluency （ WF ） and tower of London （ TL）, TL showed floor effects （ zero score） （ 3.4%, 8 ）, while DS （ 0. 85%, 2 person-times）, TM （ 1.72%, 4 person-times） and TL （0. 85% , 2 person-times） showed ceiling effects （full score） . （2） The test-retest reliability coefficient of these subtests were 0. 85, 0. 73, 0. 66, 0. 64, 0. 83, 0. 64, and 0. 58 respectively （ Ps 〈 0. 01 ）, with testretest reliability of composite score of 0. 85 （P 〈0. 01 ） . （3） Except for no statistical significance between TL and CF, there were significant correlations between other subtests scores and BACS composite score （ r = 0. 23 - 0. 66, Ps 〈 0. 01 ） . （4） There were no significant differences between version A and version B of VM and TL in BACS （P 〉 0. 05 ） . （ 5 ） BACS was positively correlated with MCCB, RAVEN, WCST completed categories, WCST correct responses, and STROOP （ r = 0. 83, 0. 51, 0. 48, 0. 40 and 0. 50, respectively ; Ps 〈 0. 001 ） ; （ 6 ） The exploratory factor analysis was completed to determine three factors, including working memory and executive function, semantic fluency, and processing and motor speed, with accumulative explained percentage of 72. 6%. Conclusion： BACS is suitable for Chinese schizophrenic patients as a clinical tool for cognitive function assessment, and is worth being revised and modified further.