青少年阴性与阳性症状精神分裂症患者的跨时决策比较研究

A comparative study of intertemporal choice in adolescents schizophrenic patients with positive and negative symptoms

目的探讨阴性与阳性症状为主的青少年精神分裂症患者的跨时决策受损情况。方法采用跨时决策范式，对阴、阳性症状为主青少年精神分裂症患者各30例及50例健康对照进行跨时决策的研究。结果（1）now选择条件下[（37．22±30．92）％，（19．67±16．35）％，P〈O．05）]、not—now选择条件下[（35．74±31．69）％，（19．33±18．07）％，P〈0．05）]和总体中[（36．48±30．44）％，（19．50±13．82）％，P〈O．05）]，阴性症状组选择延迟的较大奖赏选项的比例显著高于健康对照组，差异有统计学意义；nOW选择条件下[（37．22±30．92）％，（20．37±22．33）％，P〈O．05）]、not—now选择条件下[（35．74±31．69）％，（22．04±22．05）％，P〈O．05）]和总体中[（36．48±30．44）％，（21．20±21．57）％，P〈O．05）]，阴性症状组选择延迟的较大奖赏选项的比例显著高于阳性症状组，差异有统计学意义；阳性症状组与对照组之间在不同条件下LL选择的比例，差异无统计学意义（P〉0．05）。（2）Pearson相关分析显示阴性症状组／lOW条件下LL选择比例与词汇流畅性（r=0．411，P=0．024）显著正相关。结论阴性症状为主的青少年精神分裂症患者跨时决策能力明显受损，阳性症状为主的青少年精神分裂症患者跨时决策损伤不明显；阴性症状青少年精神分裂症患者跨时决策与认知执行功能相关。

Objective To investigate the impairment of intertemporal choices in adolescents with positive and negative schizophrenic symptoms. Methods 30 adolescent schizophrenia patients with positive symptoms （positive symptoms group）, 30 adolescent, schizophrenia patients with negative symptoms （negative symptoms group） and 30 healthy controls were selected. All the subjects were investigated with intertemporal- choice Test. Results （1） Under now conditions （（37.22±30.92） %, （19.67±16.35） %,P〈0.05） ） ,not- now conditions （ （ 35.74± 31.69） % , （ 19.33± 18.07 ） %, P〈 0. 05 ） ） and overall condition （ （ 36.48 ± 30. 44） %, （ 19.50±13.82） %, P〈 0.05 ） ）, the ratio of later-large （LL） choice in negative symptoms group were significantly higher than those in the healthy controls. Under now conditions （（37.22±30.92） %, （20.37±22. 33 ） %, P〈0.05） ） , not-now conditions （ （ 35.74±31.69） %, （ 22.04±22.05 ） %, P〈0.05 ） ） and overall condi- tion （（36.48±30.44） %, （21.20＋21.57）% ,P〈0.05））,the ratio of LL choice in negative symptoms group were significantly higher than those in positive symptoms group. There were no differences in the ratio of LL choice between positive symptoms group and healthy controls （P〉 0.05 ）. （ 2 ） Pearson correlation analysis showed that the Vocabulary Fluency Test of negative symptoms group was positively correlated with LL selec- tion ratio under now conditions （ r= 0.411, P= 0.024）. Conclusion The ability of intertemporal choices in adolescents schizophrenia patients with negative symptoms is impaired remarkably ,while this kind of ability is impaired unremarkable in adolescence with negative symptoms. The ability of intertemporal choices in adoles- cents schizophrenic patients with negative symptoms is correlated with cognitive executive function.