首发精神分裂症患者的心理弹性与认知功能的相关性

The relationship of resilience with cognitive function in patients with first-episode schizophrenia

目的分析精神分裂症(SCZ)患者心理弹性与认知功能水平的相关性。方法入组首发SCZ患者59例(SCZ组)和健康对照者86名(HC组),SCZ患者为2017年9月到2020年1月在中山大学附属第三医院精神科门诊及住院部患者。健康对照者经过广告招募入组,比较两组心理弹性、认知功能水平,分别对两组的心理弹性和认知功能进行偏相关分析。结果对SCZ组和HC组一般情况对比分析,两组的性别、婚姻及年龄差异无统计学意义(均P>0.05),其中SCZ组男39例,女20例,年龄(23.8±7.4)岁,HC组男47名,女39名,年龄(22.9±4.7)岁;受教育年限差异有统计学意义(P<0.05)。SCZ组的心理弹性总分[(56.9±16.7)分]及各因子分均显著低于HC组的心理弹性总分[(68.0±14.4)分]及各因子分(均P<0.05)。SCZ组的精神分裂认知功能成套测验MCCB总分[(23±12)分]及各分测验分显著低于HC组的认知功能成套测验总分[(42±11)分]及各分测验分(均P<0.05)。SCZ组的心理弹性总分及坚韧性与符号编码呈正相关[偏相关系数(PCC)分别为0.286、0.289,均P<0.05)],心理弹性总分及各因子分均与情绪管理能力呈正相关(PCC分别为0.334、0.271、0.382、0.308,均P<0.05)。HC组的心理弹性总分、坚韧性、力量性与符号编码呈正相关(PCC分别为0.268、0.225、0.291,均P<0.05),力量性、乐观性与语言记忆呈正相关(PCC分别为0.268、0.225,均P<0.05);力量性与空间广度、持续操作能力呈正相关(PCC分别为0.244、0.217,均P<0.05);心理弹性总分及各因子分均与情绪管理能力呈正相关(PCC分别为0.306、0.230、0.286、0.289,均P<0.05);心理弹性总分、力量性、乐观性均与MCCB总分呈正相关(偏相关系数分别为0.291、0.359、0.287,均P<0.05)。结论首发SCZ患者的心理弹性及认知功能均有不同程度受损,心理弹性水平与部分神经认知功能和社会认知功能中情绪管理能力相关。

Objective To investigate the correlation between resilience and cognitive function in patients with schizophrenia.Methods Fifty-nine patients with first-episode schizophrenia and 86 healthy controls were enrolled.Patients with schizophrenia were enrolled from the psychiatric outpatient and inpatient Department of the Third Affiliated Hospital of Sun Yat-sen University from September 2017 to January 2020,while healthy controls were recruited through advertising.The levels of resilience and cognitive function were compared between the two groups.Meanwhile,the partial correlation analysis of resilience and cognitive function of the two groups was performed.Results There was no statistically significant difference in gender,marriage and age between the two groups(all P>0.05),and there were 39 males and 20 females with an average age of(23.8±7.4)years in the schizophrenia group,while 47 males and 39 females with an average age of(22.9±4.7)years in the healthy control group.However,there was a significant difference inyears of education between the two groups(P<0.05).The total score of resilience[(56.9±16.7)vs(68.0±14.4)]and scores ofthree factorsin patients with schizophrenia were significantly lower than that in healthy controls(all P<0.05).The total score of MATRICS Consensus Cognitive Battery(MCCB)[(23±12)vs(42±11)]and each subscale score in patients with schizophrenia were significantly lower than that in healthy controls(all P<0.05).Partial correlation analysis showed that the total score of resilience and tenacity were correlated with symbol coding of schizophrenia(partial correlation coefficients were 0.286,0.289,respectively,both P<0.05).The total score of resilience and the scores of tenacity,strength and optimism were all correlated with emotion management ability of schizophrenia(partial correlation coefficients were 0.334,0.271,0.382,0.308,respectively,all P<0.05).In the healthy controls,the total score of resilience,tenacity and optimism were correlated with symbol coding(partial correlation coefficients were 0.268,0.225,0.291,respectively,all P<0.05).Strength and optimism were correlated with Hopkins verbal learning test(HVLT)(partial correlation coefficients were 0.268,0.225,respectively,both P<0.05).Strength was correlated with spatial span,continuous performance test(partial correlation coefficients were 0.244,0.217,respectively,bothP<0.05).The total scores of resilience and tenacity,strength and optimism were correlated with emotional management ability(partial correlation coefficients were 0.306,0.230,0.286,0.289,respectively,all P<0.05),while the total scores of resilience,strength and optimism were correlated with the total score of MCCB(partial correlation coefficients were 0.291,0.359,0.287,respectively,all P<0.05).Conclusion The current study suggests that resilience and cognitive function of patients with first-episode schizophrenia areimpaired significantly.Resilience in patients with schizophrenia isrelated to partial neurocognitive function and emotion management ability in social cognitive function.