首发及慢性精神分裂症患者与健康人认知功能的差异

Study of cognitive function between first-episode schizophrenia,chronic schizophrenia and normal control

目的比较首发及慢性精神分裂症与健康人认知功能的差异，并探讨影响认知功能的相关因素。方法符合美国精神障碍诊断与统计手册第四版（DSM—Ⅳ）诊断标准的首发精神分裂症住院患者90例，慢性精神分裂症患者89例，健康人94例；使用重复性神经心理测查系统（RBANS）检测认知功能，阳性和阴性症状量表（PAN-SS）、临床总体印象量表（CGI）评估患者精神症状及严重程度，Simpson锥体外系不良反应量表（SEPS）、异常不自主运动评定量表（AIMS）评定锥体外系不良反应及迟发性运动障碍。结果三组教育年限之间差异有统计学意义（F=41，P〈0．001），即刻记忆和延时记忆因子在慢性患者和首发患者之间差异不显著，无统计学意义（P=0．42，P=0.13），RBANS总分及其它因子分在三组之间均有显著性差异（P〈0.05—0．001）；慢性患者的受教育年限、既往住院次数、病程、精神症状、AIMS、SEPS与认知功能存在着显著相关性（P〈0．05～0．000）；首发患者的年龄、受教育年限、首次精神症状发生年龄、精神症状、CGI与认知功能存在着显著相关性（P〈0．05—0．000）。结论认知功能障碍是精神分裂症的核心症状之一；影响首发精神分裂症和慢性分裂症患者认知功能的因素有一定的差异。

Objective To compare cognitive functions among first - episode schizophrenia, chronic schizophrenia and normal control,and to explore the related factors effecting cognitive functions. Methods Cognitive functions were tested with Repeatable Battery for the Assessment of Neuropsychologieal Status （RBANS） for 90 first - episode inpatient schizophrenia,89 chronic schizophrenia and 94 normal controls. Psychiatric symptoms and severity were evaluated with PANSS, CGI ,Extrapyramidal side- effects were assessed with Simpson for extrapyramidal side effects scale（SEPS） and tardive dysikinesia with AIMS. Results There are significant difference in education years among three groups（ F = 41 ,P 〈 0. 001 ）. No significant difference exists in immediate memory and delay memory subscale between first - episode and chronic schizophrenia （ F = 42, P = 0. 13 ）, but total score of RBANS and the other subscales exist significant difference among three groups （P 〈 0. 05 -0. 001 ）. The remarkable correlation exist between education years,the number of previous hospitalization, course of disease,psychiatric symptoms,AIMS,SEPS and cognitive functions（P 〈0. 05 -0. 000）. There are obvious correlation between age of first- episode schizophrenia,education years, age of first symptom- attack psychiatric symptoms,CGI and cognitive functions （P 〈 0.05 - 0. 000）. Conclusion Cognitive dysfunction is one of the core symptoms in schizophrenia. There are some difference in factors effecting cognitive function between first - episode schizophrenia and chronic ones.