不同性别慢性精神分裂症患者认知功能损害的比较

Gender differences in cognitive dysfunction among chronic schizophrenics

目的:探讨慢性精神分裂症患者认知功能损害的性别差异。方法:选择符合《美国精神障碍诊断与统计手册》第4版(DSM-IV)诊断标准的慢性精神分裂症住院患者75例,其中男性组31例,女性组44例。采用阳性和阴性症状量表(PANSS)评定患者临床症状;重复性成套神经心理状态测验(RBANS)检测患者认知功能。结果:控制年龄因素后,经协方差分析发现慢性精神分裂症患者RBANS总分两组之间差异无统计学意义(P>0.05);女性组在视觉空间(F=13.32)、故事复述(F=7.40)、图画命名(F=8.14)、图形临摹(F=5.61)、线条定位(F=15.62)、数字广度测验(F=10.97)上得分比男性组低,差异均有统计学意义(P均<0.01)。相关分析发现RBANS总分与性别(r=0.27)、受教育年限(r=0.24)呈正相关(P均<0.05);与年龄(r=-0.26)、病程(r=-0.24)、阴性症状(r=-0.42)、一般精神病理症状(r=-0.24)和PANSS总分(r=-0.40)呈负相关(P<0.05或P<0.01)。结论:慢性精神分裂症患者中女性认知功能受损较男性更为明显。

Objective: To investigate the gender differences in cognitive dysfunction of chronic schizophrenic patients. Method:75 inpatients(31 males and 44 females) who were diagnosed as schizophrenia according to the criteria of Diagnostic and Statistical Manual of Mental Disorders,fourth edition(DSM-IV) were enrolled in this study.Psychiatric symptoms were evaluated with the Positive and Negative Symptoms Scale(PANSS),and cognitive function was evaluated with Repeatable Battery for the Assessment of Neuropsychological Status(RBANS). Results:After control of age,the covariance analysis results showed no significant difference in total RBANS scores for both groups,but female patients had significant lower visual space(F=13.32),story recall(F=7.40),picture naming(F=8.14),graphic copy(F=5.61),line orientation(F=15.62) and digit span indices(F=10.97)(all P<0.01).Correlation analysis showed that the RBANS had positive correlations with genders(r=0.27) and education(r=0.24)(both P<0.05), and negative correlations with age(r=-0.26),duration of illness(r=-0.24),negative symptoms(r=-0.42), general psychopathology(r=-0.24) and PANSS total scores(r=-0.40)(P<0.05 or P<0.01). Conclusion: Female patients with chronic schizophrenia suffer more serious cognitive dysfunction than male patients.