首发男性精神分裂症患者认知功能损害与精神症状的关联

Correlation between cognitive function and psychiatric symptoms in first-episode male schizophrenia pa-tients

目的 探讨首发男性精神分裂症患者认知功能的损害特点,以及认知功能损害与精神症状的关联性.方法 对43例符合精神分裂症诊断标准首次发作男性患者,在其精神症状好转前后,即治疗前与治疗8周后分别用华文认知能力测验（CCAS）和阳性及阴性症状量表（PANSS）评定,同时对患者的临床特征进行研究.结果 首发男性精神分裂症患者治疗前后认知功能与精神症状评分差异有统计学意义（P＜0.01）.精神症状治疗前患者认知能力总分[（85.7 ±11.5）分]以及各认知功能因子学习能力[（17.9±2.3）分]、推理能力[（16.1±3.4）分]、加工速度[（16.9±2.1）分]、工作记忆[（13.8±2.6）分]、空间/计算[（17.5±2.9）分]、言语智商[（86.8±11.7）分]、操作智商[（83.9±12.4）分]；精神症状治疗后患者认知能力总分[（97.6±14.3）分]以及各认知功能因子[学习能力（20.1±2.9）分、推理能力（18.9±3.1）分、加工速度（19.7±1.8）分、工作记忆（15.7±2.5）分、空间/计算（20.8±2.5）分、言语智商（98.3±13.7）分、操作智商（95.8±14.6）分,P＜0.01].治疗前后IQ的差值与PANSS总分差值及阳性总分差值具有正相关性（r值分别为0.596及0.783）.结论 （1）首发男性精神分裂症患者在发病初期就存在认知功能损害；（2）非典型抗精神病药改善精神分裂症临床症状的同时对改善患者认知功能损害具有一定作用；（3）精神分裂症患者认知功能的改善与患者阳性症状的好转具有一定的正相关,而与阴性症状改善相关无统计学意义.

Objective To study the characteristic of cognitive function impaired and its relationship with the psychiatric symptoms in patients with first-episode schizophrenia.Methods 43 first-episode male schizophrenia patients diagnosed with DSM-Ⅳ were recruited in the study and received the atypical antipsychotics treatment 8weeks.The total score and sub-scores of Chinese Cognitive Ability Scale （CCAS）were obtained for all the patients pre-and post-treatments,and the patients were also assessed by the Positive and Negative Syndrome Scale （PANSS）.Results The differences of the intelligence quotient（IQ） and its cognitive function factors between pre-and post-treatment of the patients were significant（P〈 0.01）.The total IQ score （85.7 ± 11.5）,learning ability （17.9± 2.3）,reasoning ability （16.1 ± 3.4）,processing speed （16.9 ± 2.1）,working memory （13.8 ± 2.6）,space/calculate （17.5 ± 2.9）,verbal IQ （86.8 ± 11.7）,performance IQ （83.9 ± 12.4） before treatment and cognitive score （97.6 ± 14.3） as well as cognitive function factor （learning ability （20.1 ± 2.9）,reasoning ability （18.9± 3.1）,processing speed （19.7 ± 1.8）,working memory （15.7 ± 2.5）,space/calculate （20.8 ± 2.5）,verbal IQ （98.3 ± 13.7）,performance IQ （95.8 ± 14.6） after treatment,there were significant differences pre-and posttreatment （P 〈 0.01）.The difference of IQ pre-and post-treatment was significantly correlated with that of total score and positive score of PANSS（r =0.596 or 0.783）.Conclusions （1） This finding supports that the cognitive function impairment exists in the early stage of schizophrenia.（2）The typical antipsychotic drugs can improve the cognitive function impairment and psychiatric symptoms of schizophrenia.（3） The cognitive function impairment of schizophrenia has significant relation to the positive symptoms,but no relation to the negative symptoms.