精神分裂症患者情绪认知缺陷、述情障碍和情感淡漠的相关性研究

A correlation study of emotion recognition, alexithymia and flat affect in schizophrenic patients

目的探讨精神分裂症患者面孔情绪认知缺陷、述情障碍和情感淡漠症状的相关性。方法采用中国人面孔情绪测验（CFET）和多伦多述情障碍量表（TAS-26）对82例精神分裂症患者进行测试，与88名正常健康者比较，同时对患者作阴性症状量表（SANS）情感淡漠或迟钝分量表评定。结果精神分裂症患者CFET总分及6种基本情绪认知评分均显著低于对照组（P〈0．01），TAS的总分、因子1、因子2和因子4评分均显著高于对照组（P〈0．01）。相关分析显示，患者CFET正确数评分与TAS的总分、因子1、因子2和因子4评分呈负相关，35项相关系数中27项（71．4％）差异有显著性。情感淡漠或迟钝分量表评分与一些CFET评分呈负相关，49项相关系数中9项（18．4％）差异有显著性，而与TAS评间，除眼神接触差评分与TAS总分呈正相关外（r=0．272，P=0．014），余变量间相关均差异无显著性。结论分裂症患者的广泛的面孔情绪认知缺陷与述情障碍可能更多地反应了一种素质性特征，存在某种共同的病理生理基础，而述情障碍与情感淡漠间可能具有不同的病理性情绪处理过程。

Objective To analyze the correlation between the facial emotion deficits and alexithymia or flat affect in patients with schizophrenia. Methods Eighty-two schizophrenic patients and eighty-eighi healthy subjects were tested with the Chinese Facial Emotion Test （CFET）and Toronto Alexithymia Scale（ TAS-26 ） , and rated on the flatten affective subscale of the SANS. Results For patients with schizophrenia, the total correct score and scores of recognition for each of six basic emotions were significantly less（P〈0.01 ）, and the scores of factor Ⅰ, Ⅱ, or Ⅳ on TAS-26 were significantly more （P 〈 0.01 ） than that of controls. There was a significantly negative correlation between scores of CFET and the scores of factor Ⅰ, Ⅱ, or Ⅳ on TAS-26, in which 27 of 35 （71.4%） correlation coefficients reach statistic significance, and also a significantly negative correlation between some scores of CFET and flatten affective subscale of the SANS, in which 9 of 49 （ 18.4% ） correlation coefficients reach statistic significance. There was no significant correlation between scores of TAS-26 and subscales of symptom, apart from subscale of eye attach. Conclusion The impairment of facial emotion recognition as well as alexithymia indicated a special trait in schizophrenics, both of two symptoms may be involved in a common neural substrates, while the dissociation between alexithymia and flatten affection may suggested a different pathological emotion processing.