神经心理测验预测首发精神分裂症的近期预后

Relationship of neurocognitive functioning to clinkal prognosis in first-episode schizophrenic patients

目的 筛选与首发精神分裂症近期预后有关的神经心理测查指标。方法 对164例首发精神分裂症患者随机给予氯丙嗪或氯氮平治疗,于治疗前分别作韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、手指敲击测验、利手测验、动作功能测验、手功能协调测验、连线测验A、连线测验B、威斯康辛卡片分类测验(WCST)及语言流畅性测验等11项神经心理测查各1次,并作BPRS、SANS、功能总体评定量表(GAF)各1次,治疗12周时再评定1次BPRS、SANS、GAF。结果 神经心理测查结果与阳性、阴性精神病性症状无显著相关性,但某些指标尤其是WCST、连线测验、动作功能测验、语言流利性测验等对预测首发精神分裂症的近期预后有显著意义。结论 WCST、连线测验等神经心理功能指标可预测首发精神分裂症的近期疗效及社会功能转归。

Objectives: To identify the cognitive factors related to the prognosis of first-episode schizophrenic. Method: First-episode schizophrenic patients (n = 164) were administered 11 neuropsy-chological tests prior to randomly assigned treatment with chlorpromazine or clozapine: Weschler Adult Intelligence Scale, Weschler Memory Scale, Grooved Pegbord Test, Finger Tapping Test, Edinburgh Hand-edness Test, Trail Making Test A and B (TMT), Wisconsin Card Sorting Test (WCST), a Motor Function Test (MFT), a Hand Coordination Test and a Verbal Fluency Test (VFT). Clinical status was assessed prior to treatment and 12 weeks after treatment using the Brief Psychiatric Rating Scale, the Scale for Assessment of Negative Symptoms, and the Global Assessment of Functioning. Results: Pre-treatment neurocognitive functioning was not related to the severity of positive or negative symptoms before treatment , but some factors including WCST, TMT, MFT, VFT could predict the prognosis of first-episode schizophrenia. Conclusion: Neurocognitive functioning such as WCST, TMT, VFT could predict clinical efficacy and social function outcome.