偏执型与未定型精神分裂症患者执行功能的对照研究

Comparison of the executive function of patients either with paranoid or undifferentiated schizophrenia

目的:探讨偏执型与未定型精神分裂症患者执行功能的特点。方法:采用威斯康星分类卡片测验(WCST)分别对处于发作期、未服药治疗的符合《精神障碍诊断统计手册第四版》(DSM-Ⅳ)精神分裂症诊断偏执型的26例患者(偏执型组)、未定型的27例患者(未定型组)和36例健康对照者(对照组)的执行功能进行评估,并以阴阳性症状量表(PANSS)评定患者症状。结果:(1)在WCST中,偏执型和未定型分裂症患者的总反应数、随机错误数、错误应答百分率和随机错误应答百分率(偏执型组分别为95.31±23.12、43.42±26.20、72.98±10.50和43.56±19.15;未定型组分别为91.22±25.07、40.22±25.77、72.79±15.03和41.69±18.51)均高于对照组(分别为66.72±26.40、19.94±15.79、56.71±15.99和25.84±13.24)(均P<0.001);两患者组正确应答百分率(偏执型组为26.77±10.13,未定型组为28.42±12.25)均低于对照组(43.28±15.99)(均P<0.001);两患者组正确反应数、持续错误数、完成分类数、持续错误应答百分率与对照组之间的差异无显著性。偏执型与未定型组各项指标之间的差异无显著性。(2)偏执型组PANSS量表妄想症状评分显著高于未定型组,WCST结果与妄想症状评分无相关关系。结论:处于急性发作期的偏执型和未定型精神分裂症患者均存在执行功能缺陷,与PANSS量表妄想症状评分无相关关系。

Objective To explore the characteristics of the executive function of patients either with paranoid or undifferentiated schizophrenia. Methods Wisconsin card sorting tests （WCST） were administered to evaluate the executive function of 26 patients with paranoid schizophrenia （paranoid group）, 27 patients with undifferentiated schizophrenia （undifferentiated group）, and 36 normal controls （control group）, and the syndrome of the patients with schizophrenia were assessed by positive and negative syndrome scale （PANSS）. Results As compared with those in control group, the number of total trials, random errors, the rate of error responses, the rate of random errors in paranoid group and undifferentiated group were higher, while the rate of correct responses was lower. There was no significant difference in WCST between paranoid group and undifferentiated group. The delusion score in paranoid group was significantly higher than that in undifferentiated group, and there was no significant correlation between the increased scores of delusion score and WCST. Conclusions There existed executive dysfunction in patients either with paranoid or undifferentiated schizophrenia, which was not correlated with delusion scores.