首发精神分裂症与双相障碍及抑郁障碍认知功能比较

The comparison of impairment of cognitive function in first-episode schizophrenia,bipolar disorder and major depressive disorder

目的探讨首发精神分裂症、双相障碍及抑郁障碍患者认知功能差异。方法纳入首发精神分裂症患者61例,双相障碍患者57例,抑郁障碍患者48例,另设正常对照59名。所有研究对象采用重复性神经心理测查系统(Repeatable Battery for the Assessment of Neuropsychological Status,RBANS)评估认知功能,首发精神分裂症组采用阳性和阴性症状量表(positive and negative syndrome scale,PANSS)评定精神病性症状,双相障碍组、抑郁障碍组采用汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评估抑郁和焦虑症状,贝克—拉范森躁狂(Bech-Rafaelsen mania scale,BRMS)量表评估躁狂症状。结果 4组对象的RBANS总分(F=5.18,P<0.01)、即刻记忆(F=4.09,P<0.01)、言语功能(F=9.53,P<0.01)、注意(F=3.87,P=0.01)、延时记忆(F=9.86,P<0.01)因子得分差异具有统计学意义,其中首发精神分裂症、双相障碍组RBANS总分低于对照组(P<0.01),首发精神分裂症、双相障碍、抑郁障碍组即刻记忆、言语功能、延时记忆得分低于对照组(P<0.05),双相障碍组言语功能得分低于首发精神分裂症组(P<0.01),首发精神分裂症组注意得分低于抑郁障碍及对照组(P<0.01)。结论首发精神分裂症、双相障碍、抑郁障碍患者均存在认知功能损伤,首发精神分裂症认知功能缺陷重于抑郁障碍,轻于双相障碍。

Objective To evaluate impairment of cognitive function in first-episode schizophrenia, bipolar disor- der and major depressive disorder. Methods Sixty one first-episode schizophrenia patients, fifty seven bipolar disorder patients, forty eight major depressive disorder patients and fifty nine healthy controls were recruited. Cognitive function of all subjects was assessed using Repeatable Battery for the Assessment of Neuropsyehological Status （RBANS）. The psychiatric symptoms of schizophrenia patients and the depressive, anxiety symptoms and manic symptoms of bipolar dis- order patients and major depressive patients were assessed using positive and negative syndrome scale （PANSS）, Hamil- ton depression scale （HAMD）, Hamilton anxiety scale （HAMA） and Bech-Rafaelsen mania scale （BRMS）, respectively. Results The total score of RBANS （F=5.18, P〈0.01）. and the factor scores of immediate memory （F=9.53, P〈0.01）, de- layed memory （F=3.87,/9=-0.01） and language function （F=9.86, P〈0.01） were significantly different in four groups. Compared to healthy controls, the total score of RBANS were significantly lower in first-episode schizophrenia group and hi-polar disorder group （P〈O.01）, and the factor scores of immediate memory, delayed memory and language function were significantly lower in first-episode schizophrenia group, bipolar disorder group and major depressive group （P〈0.05）. Ma- jor depressive group performed worse than first-episode schizophrenia group in language function factor （P〈0.01）. The factor score of attention in first-episode schizophrenia group was significantly lower than major depressive and control group （P〈O.01）. Conclusions First-episode schizophrenia, bipolar disorder and major depressive disorder are associated with significant cognitive impairments. Cognitive function impairments in the patients with first-episode schizophrenia are worse than patients with major depressive disorder, but better than patients with bipolar disorder.