首发精神分裂症患者与超高危人群认知功能的对照研究

Control study of cognitive function in ultra-high risk population of schizophrenia and first-episode schizophrenia patients

目的:对比首发精神分裂症患者,与精神分裂症超高危人群的神经认知功能特点及相关因素。方法:分别纳入30例首次发作未接受过系统治疗的精神分裂症患者(患者组)、30例来自一级亲属中的超高危人群-精神病风险综合征者(超高危组),以及30例健康志愿者(对照组)作为被试对象,采用连线测验(TMTA)、精神分裂症简易认知评估:符号编码、霍普金斯词语学习测验修订版(HVLT-R)、简易视觉记忆测验-修订版(BVMT-R)、Stroop色词测验持续操作测验(CPT)、威斯康星卡片分类测验(WCST)对注意力、学习和记忆、信息处理速度以及执行功能4个领域进行全面评定。结果:与正常对照组相比,首发精神分裂症患者在认知功能注意能力/警觉性、学习与工作记忆、信息处理速度及执行功能4个领域的差异有统计学意义(P<0.05),而超高危组则在除空间记忆(BVMT-R)和信息处理速度中的TMTA测验外的其它方面均与对照组存在差异(P<0.05),差异小于患者组。认知功能指标中仅CPT与病程呈负相关(P<0.05),WCST持续错误数与PANSS得分呈正相关(P<0.05)。结论:精神分裂症高危人群存在相对广泛的认知功能损害,但轻于首发精神分裂症患者,认知功能缺陷可能是精神分裂症的素质指标之一。

Objective： To study and compare the characteristics of neuron-cognitive function of the patients with first-episode schizophrenia and the high-risk groups （psychosis risk syndrome）, and to discuss related risk factors. Methods： Thirty patients with the first-episode schizophrenia and no systematic treatment, 30 cases with psychosis risk syndrome of schizophrenia the first degree relatives, and 30 healthy volunteers were selected to he patients group, very high risk group and control group, respectively. The connection test （TMTA） and schizophrenia easy cognitive assessment were applied： Symbol coding, Hopkins Verbal Learning Test Revised （HVLT-R）, simple visual memory test - revised edition （BVMT-R）, Stroop color word quiz continuous performance test （CPI）, Wisconsin card sorting test （WCST） on attention, learning and memory, information processing speed were used to estimate the cognitve function to conduct a comprehensive evaluation of executive function in four areas. Results： Compared with normal control group, cognitive function in attention capacity/alertness, learning and working memory, information processing speed, and executive function in the first-episode schizophrenia had statistically significant differences （P〈0.05）. Except for the spatial memory （BVMT-R） and the TMTA of the information processing speed ,the cognitive function measured in the very high risk group were significantly worsened compared to the control group. The differenc.es between the two groups were statistically significant （P〈0.05）. With the extent of the difference slighter than compared with the patient group. Among indicators of cognitive function, only CPT was negatively correlated with disease duration （P〈0.05） and WCST preservative errors were positively correlated with PANSS scores （P〈0.05）. Conclusion： Widespread cognitive impairments exist among high risk schizophrenia group, which are not severe compared with first-episode schizophrenia patients. Cognitive impairments might be a quality indicator for schizophrenia.