精神分裂症与强迫症错误监控功能改变的比较研究

A comparative study of error-monitor function between first episode schizophrenia and obsessive-compulsive disorder

目的:探讨精神分裂症和强迫症患者错误相关负电位(ERN)变化特征及与临床症状的相关性。方法:对64例精神分裂症和59例强迫症患者及56名健康成人进行ERN检测、阳性与阴性症状量表(PANSS)及耶鲁-布朗强迫量表(Y-BOCS)评估,并对结果进行相关分析比较。结果:精神分裂症组和强迫症组ERN的正确反应率明显低于正常对照组;正确反应和错误反应的反应时明显长于正常对照组(P均<0.01)。与正常对照组相比,精神分裂症组ERN波幅降低、潜伏期延长,强迫症组ERN波幅增高(P<0.05或P<0.01)。ERN潜伏期和波幅变化与精神分裂症阳性症状及PANSS总分(r=0.088,P>0.05)、强迫症组ERN波幅与Y-BOCS评分之间不相关(r=0.117,P>0.05)。结论:精神分裂症的ERN波幅降低及强迫症的ERN波幅增高可能反映两组患者内在错误监控机制存在缺陷。

Objective: To explore the variations of error-related negativity(ERN) in first episode schizophrenia and obsessive-compulsive disorder. Method:The ERN was tested in 64 first episode schizophrenia(FES),59 obsessive-compulsive disorder(OCD) and 56 normal controls(NC).Positive and Negative Syndrome Scale(PANSS) and Yale-Brown Obsessive Compulsive Scale(Y-BOCS) were administrated to all subjects. Results:The correct response rates were significantly lower in the FES and OCD groups than those in the NC group,and the reaction periods of correct responses and incorrect responses were significantly longer in the FES and OCD groups than those in the NC group.Compared with those in the NC group,the ERN amplitudes were significantly lower(P<0.05) and ERN latencies were significantly longer(P<0.01) in the FES group,the ERN amplitudes were significantly higher in the OCD group(P<0.01).The variations of ERN latencies and amplitudes did not show significant correlation with the positive symptom scores and total scores of PANSS in FES(r=0.088,P>0.05),and there was no correlation between the variations of ERN latencies and amplitudes and the Y-BOCS scores in OCD(r=0.117,P>0.05). Conclusion: ERN amplitudes become lower in FES patients and higher in OCD patients.These changes may reflect the deficiency on error-monitoring function in FES and OCD patients.