精神分裂症患者自我面孔识别能力及其与失言识别和执行功能的相关性研究

Self-face recognition in schizophrenia：association with faux pas recognition and executive function

目的探讨精神分裂症患者自我面孔识别能力及其与失言识别能力和执行功能的关系。方法采用自我面孔识别任务（SFRT）、失言识别测试（FPT）和威斯康星卡片分类测验（WCST）对年龄、性别、文化程度相匹配57例门诊和住院精神分裂症患者（患者组）及50名健康对照者（对照组）的自我面孔识别能力、失言识别能力和执行功能进行测试；采用Spearman相关分析比较自我面孔识别能力与失言识别能力和执行功能的相关性。结果（1）SFRT：患者组平均反应时[（2122±1124）ms]长于对照组[（1180±322）ms，P〈0．01]，正确率[（80±16）％]低于对照组[（88±6）％，P〈0．01]。（2）FPT：患者组总分[（42．20±14．52）分]、失言故事分[（29．98±15．64）分]和控制故事分[（12．22±5．62）分]均低于对照组[分别为（67．58±8．12）、（52．16±7．14）、（15．36±4．12）分，P〈0．05或P〈0．01]。（3）WCST：除完成分类数和非持续性正确数外，患者组与对照组间其他各项WCST指标差异均具有统计学意义（P〈0．05或P〈0．01）。（4）相关分析显示，患者组SFRT正确率与FPT失言故事分间呈正相关（r=0．328，P〈0．05），与WCST总应答数（r=-0．282，P〈0．05）、错误应答数（r=-0．278，P〈0．05）、持续应答数（r=-0．397，P〈0．01）和非持续性错误数（r=-0．395，P〈0．01）呈负相关。结论精神分裂症患者存在自我面孔识别能力、失言识别能力和执行功能的损害，患者自我面孔识别缺陷与心理理论和执行功能障碍可能具有某种共同的病理生理基础。

Objective To explore the self-face recognition and its relationship to faux pas recognition and executive function in patients with schizophrenia. Methods Fifty-seven schizophrenic patients without treatment and fifty age, gender and years of education matched healthy subjects were assessed using Self-face Recognition Task（SFRT） , Faux Pas Test （FPT） and Wisconsin Card Sorting Test （WCST）. The correlation between self-face recognition, faux pas recognition and executive function using Spearman correlation analysis. Results Schizophrenic patients showed increased reaction time and lower accuracy for self-face recognition compared to normal controls [ （2122 ± 1124） ms vs. （1180 ± 322） ms; （80 ± 16）% vs. （88 ±6）% ; all P 〈0. 01 ]. Compared with healthy subjects （67.58 ± 8.12, 52.16 ± 7.14, 15.36 ± 4.12）, schizophrenic patients （42.20 ± 14.52, 29.98 ± 15.64, 12.22 ± 5.62） had significantly less score in Faux Pas Test（ P 〈 0.05 -0.01 ）. Besides the sub-scores of categories completed and non-perseverative corrects, there were significantly difference on the each sub-scores of WCST between healthy subjects and schizophrenic patients （ P 〈 0. 05 - 0. 01 ） . Correlation analysis showed a negative correlation between the accuracy for self-face recognition in SFRT and the response administered （r = - 0. 282, P 〈 0. 05）, the number of responses errors （ r = - 0. 278, P 〈 0. 05 ）, perseverative responses （r = - 0. 397, P 〈 0. 01 ） and non-perseverative errors （ r = - 0. 395, P 〈 0. 01 ） in WCST. Conclusion Schizophrenic patients have general impairments of self-face recognition, faux pas recognition and executive function, and the self-face recognition deficit may shared a common pathophysiological base with faux pas and executive dysfunction.