急性期精神分裂症的基于事件前瞻记忆研究

Event-based prospective memory during acute phase schizophrenia

目的探讨急性期、近期未服药精神分裂症患者是否存在基于事件前瞻记忆缺陷。方法 49例健康志愿者入组健康对照组;51例近期未服药的急性期精神分裂症患者入组精神分裂症组,进一步分为首发精神分裂症亚组(n=23)和慢性精神分裂症亚组(n=28)。应用基于事件前瞻记忆实验范式测评前瞻记忆,再认法测评回溯记忆,空间广度测验测评视空间觉工作记忆,应用阳性与阴性症状量表(PANSS)评定患者精神症状的严重程度。结果精神分裂症组的前瞻记忆、回溯记忆和视空间觉工作记忆成绩均低于健康对照组(P分别为0.008、0.016和0.001),控制回溯记忆、视空间觉工作记忆等因素后,精神分裂症组的前瞻记忆成绩仍低于健康对照组(P<0.05)。精神分裂症组的前瞻记忆与受教育程度呈正相关(r=0.405,P<0.05),与年龄、病程、PANSS总分及阴性分均呈负相关(r分别为-0.41、-0.5、-0.345和-0.486,均P<0.05)。首发精神分裂症亚组与慢性精神分裂症亚组前瞻记忆、回溯记忆和视空间觉工作记忆成绩的组间差异均无统计学意义(均P>0.05)。结论急性期精神分裂症存在明显的基于事件前瞻记忆缺陷,首发和慢性精神分裂症患者的前瞻记忆缺陷程度相似,精神分裂症的前瞻记忆缺陷属于原发性认知缺陷。

Objective To investigate the event-based prospective memory deficit in patients with acute and drug-free schizophrenia. MethodsForty-nine healthy controls（healthy control group） and 51 patients with acute and drug-free schizophrenia（schizophrenia group） were enrolled,and the latter were further divided into first-episode schizophrenia subgroup（n=23） and chronic schizophrenia subgroup（n=28）.Prospective memory was assessed with event-based prospective memory pattern,retrospective memory was determined with recognition test,visuo-spatial working memory was examined with spatial span test,and the severity of psychotic symptoms was evaluated with Positive and Negative Symptom Scale（PANSS）. ResultsThe prospective memory,retrospective memory and visuo-spatial working memory in schizophrenia group were significantly lower than those in healthy control group（P=0.008,P=0.016 and P=0.001 respectively）.After controlling for retrospective memory and visuo-spatial working memory,the prospective memory in schizophrenia group was still lower than that in healthy control group（P0.05）.In schizophrenia group,prospective memory was positively correlated with education（r=0.405,P0.05）,and was negatively correlated with age,disease duration,PANSS total score and negative symptom score（r=-0.41,r=-0.5,r=-0.345 and r=-0.486 respectively,P0.05 for all）.There was no significant difference in prospective memory,retrospective memory and visuo-spatial working memory between first-episode schizophrenia subgroup and chronic schizophrenia subgroup（P0.05 for all）. ConclusionThere exists significant prospective memory deficit during acute phase schizophrenia,and the prospective memory deficit in first-episode patients is similar to that of the chronic patients.The prospective memory deficit in patients with schizophrenia is a kind of primary cognitive deficit.