伴与不伴抑郁症状的精神分裂症患者临床特征的性别差异

Sex differences in clinical features between schizophrenia patients with and without depressive symptoms

目的:探讨伴与不伴抑郁症状的精神分裂症患者临床症状的性别差异。方法:纳入精神分裂症患者138例及正常对照者94名,采用阳性和阴性症状量表(PANSS)评估患者的精神症状、卡尔加里精神分裂症抑郁量表(CDSS)评估患者的抑郁症状;同时运用重复性神经心理状态测验(RBANS)评估受试者的认知功能。结果:精神分裂症伴有抑郁组PANSS总分及因子分高于不伴抑郁症状组(P均<0.001),RBANS总分及因子分低于不伴抑郁症状组(P<0.05或P<0.01)。性别分层后,PANSS总分及因子分、RBANS总分及因子分在女性精神分裂症患者伴与不伴抑郁症状组间差异有统计学意义(P<0.05或P<0.01),男性伴与不伴抑郁症状组PANSS总分、阴性症状、一般精神症状分、RBANS总分及即时记忆因子分差异有统计学意义(P<0.05或P<0.01)。男、女精神分裂症患者CDSS分与PANSS总分呈正相关(P均<0.001),而CDSS评分与RBANS总分的相关性只存在于女性精神分裂症患者中(女:r=-0.334,P=0.008)。结论:伴与不伴抑郁症状的精神分裂症患者精神症状及认知功能存在男女性别差异。

Objective:To explore the sex differences in the relationship between depressive symptoms,psychotic symptoms and cognitive functions in schizophrenia.Method:A total of 138 schizophrenia patients and 94 healthy controls were enrolled.Positive and Negative Syndrome Scale(PANSS)was used to assess psychotic symptoms,and Calgary Depression Rating Scale(CDSS)for depressive symptoms in schizophrenia.In addition,the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)was used to evaluate cognitive function in all participants.Results:Compared to patients without depressive symptoms,schizophrenia patients with depressive symptoms had higher PANSS total and sub-scores(P<0.001),and a lower RBANS total and 5 sub-scores(P<0.05 or P<0.01).After stratified by sex,these differences in PANSS and RBANS between patients with and without depressive symptoms remained in females,the differences in males were only found in PANSS total score,negative symptoms,general psychotic symptoms,RBANS total score and immediate memory items(P<0.05 or P<0.01).Our correlation analysis further showed that PANSS total score was positively associated with depressive symptoms both in male and female patients(P<0.001),while the negative correlation between RBANS total score and depressive symptoms was only found in females(female:r=-0.334,P=0.008).Conclusion:There are sex differences in the psychotic symptoms and cognitive function of schizophrenia patients with and without depressive symptoms.