精神分裂症不同临床阶段患者社会认知加工的眼动特征

Eye movement characteristics of social cognitive processing in patients with schizophrenia across different clinical stages

目的探讨不同临床阶段的精神分裂症患者社会认知加工的眼动特征及其与临床症状之间的关系。方法对15例首发精神分裂症患者(首发组)、46例慢性住院精神分裂症患者(慢性组)、36例精神病临床高危综合征患者(临床高危组)和26例健康对照组采用眼动追踪技术记录四组被试对人际互动图片的眼动轨迹。采用SPSS 17.0进行协方差分析和偏相关分析。结果在观看人物交流图片时,四组被试的注视时长分别为:对照组(294.6±36.7)ms,临床高危组(280.0±54.0)ms,首发组(268.5±34.9)ms,慢性组(315.7±75.7)ms,差异有统计学意义(F=3.18,P=0.027)。观看无人风景图时,四组被试的平均跳视幅度分别为:对照组(5.3±1.1)°,临床高危组(4.7±1.1)°,首发组(5.2±1.0)°,慢性组(4.4±1.2)°,差异有统计学意义(F=3.37,P=0.021)。慢性组患者在观察人物交流图片、人物无交流图片和无人物风景图片时的注视时长均与PANSS总分成正相关(偏相关系数=0.313,P=0.039;偏相关系数=0.320,P=0.034,偏相关系数=0.372,P=0.013)。慢性组患者在观察无人物风景图片时平均注视时长与PANSS阳性症状评分成正相关(偏相关系数=0.321,P=0.034)。慢性组患者在观察任意一类图片平均注视时长与PANSS一般症状评分成正相关(人物交流图片:偏相关系数=0.385,P=0.010;人物无交流图片:偏相关系数=0.409,P=0.006;无人物风景图:偏相关系数=0.465,P=0.001)。首发组患者在观察人物无交流图片时的跳视幅度与PANSS阳性症状评分成正相关(偏相关系数=0.555,P=0.049)。临床高危组患者在观察人物交流图片时的平均跳视幅度与SOPS阳性症状评分成负相关(偏相关系数=-0.373,P=0.030)。结论精神分裂症不同临床阶段患者社会认知加工的眼动特征具有明显差异。与平均注视时长相比,跳视幅度对于临床高危期患者症状严重程度的预测更灵敏。

Objective To explore the eye movement characteristics of social cognitive processing in schizophrenia patients across different stages and its association with clinical symptoms.Methods Fifteen patients with first-episode schizophrenia,forty-six patients with chronic inpatient schizophrenia,thirty-six patients with psychiatric clinical high-risk syndrome,and twenty-six healthy controls were recorded using eye tracking technology when viewing social interaction pictures.Covariance analysis and partial correlation analysis were conducted by SPSS17.0.Results When watching the pictures of person communication,there were statistically significant differences in the average fixation duration of the four groups of subjects((294.6±36.7)ms in control group,(280.0±54.0)ms in clinical high-risk group,(268.5±34.9)ms in first-episode group,and(315.7±75.7)ms in chronic group,respectively,F=3.18,P=0.027).When viewing the pictures of no person landscape,the average saccade amplitude of the four groups of subjects was significantly different(5.3±1.1)°in control group,(4.7±1.1)°in clinical high-risk group,(5.2±1.0)°in first-episode group,and(4.4±1.2)°in chronic group,respectively,F=3.37,P=0.021).The average fixation duration of chronic patients when observing person communication pictures was positively correlated with the total score of PANSS(partial correlation coefficient=0.313,P=0.039).The average fixation duration of chronic patients when observing the other two types of pictures were also positively correlated with the total score of PANSS(partial correlation coefficient=0.320,P=0.034,no person communication pictures;partial correlation coefficient=0.372,P=0.013,no person landscape pictures).The average fixation duration of chronic patients when observing pictures of no person landscape was positively correlated with the PANSS positive symptom score(partial correlation coefficient=0.321,P=0.034).The average fixation duration of chronic patients when observing any type of picture was positively correlated with the PANSS general symptom score(person communication pictures:partial correlation coefficient=0.385,P=0.010;no person communication pictures:partial correlation coefficient=0.409,P=0.006;no person landscape pictures:partial correlation coefficient=0.465,P=0.001).In the first-episode patient,the average saccade amplitude when observing no person communication pictures was positively correlated with the PANSS positive symptom score(partial correlation coefficient=0.555,P=0.049).In the clinical high-risk group,the average saccade amplitude when observing person communication pictures was negatively correlated with the SOPS positive symptom score(partial correlation coefficient=-0.373,P=0.030).Conclusion There are statistically significant differences of eye movement characteristics of social cognitive processing in patients with schizophrenia across different clinical stages.The average saccade amplitude is more sensitive than the average fixation duration in predicting the severity of symptoms in clinical high-risk patients.