首发精神分裂症患者基于事件前瞻记忆缺陷的心理机制研究

Psychological mechanism of event-based prospec tive memory deficit in patients with first-episode schizophrenia

目的·分析首发精神分裂症患者基于事件前瞻记忆(prospective memory,PM)与正常人的差异,探索其可能的心理机制。方法·共纳入34例未服药的首发精神分裂症患者(首发精神分裂症组)及31名健康志愿者(健康对照组)。应用基于事件前瞻记忆任务测评被试的PM,其中线索识别PM任务主要测评被试的线索识别能力,意向提取PM任务测评被试的意向提取能力。同时,应用字母数字广度任务测评被试的言语性工作记忆,应用理解记忆测验测评被试的回溯记忆,应用修订版六元素测验(modified six elements test,MSET)测评被试执行多重任务的能力。应用阳性与阴性症状量表(Positive and Negative Syndrome Scale,PANSS)、精神病症状维度评定量表(Clinician-Rated Dimensions of Psychosis Symptom severity,CRDPS)及临床疗效总评量表(Clinical Global Impression,CGI)评估患者精神症状及其严重程度。结果·首发精神分裂症组的线索识别PM任务及意向提取PM任务均显著低于健康对照组(均P<0.05),言语性工作记忆及回溯记忆成绩均显著低于健康对照组(均P=0.000),而多任务执行能力的组间差异无统计学意义。控制工作记忆、回溯记忆及执行功能后,线索识别和意向提取的组间差异仍具有统计学意义(均P=0.000)。精神分裂症的线索识别能力、意向提取能力与临床症状之间无显著相关性。结论·精神分裂症患者中基于事件前瞻记忆的线索识别缺陷和意向提取缺陷可能均属于原发性认知缺陷。

Objective·To analyze the difference of the event-based prospective memory(PM)between first-episode schizophrenia(FES)patients and normal patients,and to explore its possible psychological mechanism.Methods·Thirty-four FES patients without medication(FES group)and 31 healthy volunteers(healthy control group)were enrolled.Cue identification and intention retrieval components of event-based PM were examined by using dual-task paradigm.Besides,verbal working memory was assessed by Letter-Number Span,retrospective memory was assessed by comprehension memory test,and multitasking capability was assessed by modified six-element test(MEST).The mental symptoms and their severity were evaluated by Positive and Negative Symptom Scale(PANSS),Clinician-Rated Dimensions of Psychosis Symptom severity(CRDPS)and Clinical Global Impression(CGI).Results·The cue identification PM and intention retrieval PM in the FES group were significantly lower than those in the healthy control group(all P<0.05).The results of verbal working memory and retrospective memory in the FES group were significantly lower than those in the healthy control group(both P=0.000),while there was no significant difference in the multitasking capability between the two groups.After the working memory,retrospective memory and executive function being controlled,the difference in cue identification and intention retrieval of the two groups were still significant(both P=0.000).Besides,there was no significant correlation between clue recognition ability and intention extraction ability of schizophrenia and clinical symptoms.Conclusion·Both cue identification deficit and intention retrieval deficit in event-based PM may be primary cognitive defects in patients with schizophrenia.