有无幻听的精神分裂症患者认知功能的特点及与幻听的相关性

A comparative study of cognitive function in schizophrenia patients with or without auditory hallucinations and its correlation

目的探讨精神分裂症有无幻听的患者认知功能损害的特点及其与幻听症状的相关性。方法纳入2013年5月至2019年3月武汉大学人民医院精神卫生中心收治的伴有幻听的精神分裂症患者42例(幻听组)、不伴幻听的精神分裂症患者26例(非幻听组),纳入同期武汉地区招募的健康对照82例(对照组)作为研究对象。对精神分裂症患者进行阳性和阴性症状量表评分,对3组人群进行数字符号测试、数字广度测试及言语流畅性测试评估认知功能。结果幻听组与非幻听组在年龄、性别、教育、病程及PANSS各项评分等临床症状上相匹配(除P3幻觉评分外)。与对照组[数字符号测试(69.12±9.84)分,数字广度测试顺背评分(9.00±1.02)分,数字广度测试倒背评分(6.13±1.51)分,言语流畅性测试(21.90±4.32)分]比较,伴有幻听的精神分裂症患者[(41.17±8.00)、(7.26±1.36)、(4.24±0.96)、(13.26±2.36)分]及不伴有幻听的精神分裂症患者[(48.65±13.82)、(7.54±1.48)、(4.46±1.61)、(16.11±5.29)分]认知测评得分均明显下降(F=28.65,13.18,15.05,32.26;P<0.05),且幻听组的数字符号测试评分低于非幻听组(t=-2.83,P<0.05)。相关分析结果示伴有幻听的精神分裂症患者数字符号测试评分与Hoffman幻听评分呈负相关(r=-0.34,P=0.03)。结论有无幻听的精神分裂症患者均存在广泛的认知功能损害,伴有幻听的精神分裂症患者在注意力及执行能力方面损害更为严重且与幻听症状密切相关。

Objective To compare the characteristics of cognitive function and its correlation with auditory hallucination in schizophrenic patients with or without auditory hallucination.Methods From May 2013 to March 2019,42 schizophrenic patients with auditory hallucination(auditory hallucination group),26 schizophrenic patients without auditory hallucination(non-auditory hallucination group)admitted to the mental health center of Renmin Hospital of Wuhan University,and 82 healthy controls from healthy Wuhan area in the same period were recruited as the research subjects.All schizophrenic patients were scored by positive and negative symptom scale.The Digital Symbol Test(DST),Digital Span Test(DSPT),and Verbal Fluency Test(VFT)were used to evaluate cognitive function of the three groups.Results The auditory hallucination group and the non-auditory hallucination group were matched on age,gender,education,course of disease,PANSS scores and other clinical symptoms(except for P3 hallucination score).Compared with the control group[DST(69.12±9.84);DSPT(forward)(9.00±1.02),(backward)(6.13±1.51);VFT(21.90±4.32)],the auditory hallucination group[DST(41.17±8.00);DSPT(forward)(7.26±1.36),(backward)(4.24±0.96);VFT(13.26±2.36)]and the non-auditory hallucination group[DST(48.65±13.82);DSPT(forward)(7.54±1.48),(backward)(4.46±1.61);VFT(16.11±5.29)]showed significant decrease in cognitive scores(F=28.65,13.18,15.05,32.26;P<0.05).The DST score of the auditory hallucination group was not lower than that of the nonauditory hallucination group(t=-2.83,P<0.05).Correlation analysis showed that DST score of schizophrenic patients with auditory hallucination was negatively correlated with Hoffman auditory hallucination score(r=-0.34,P=0.03).Conclusions Schizophrenic patients with or without auditory hallucination all have extensive cognitive function.Schizophrenic patients with auditory hallucination have more severe impairment in attention and executive ability,which are closely related to auditory hallucination symptoms.