缺陷型精神分裂症认知功能与病耻感相关性研究

On the relevance between cognitive function and stigma in patients with deficit schizophrenia

目的:探讨缺陷型精神分裂症患者认知功能损害及其阴性症状与病耻感之间的关联性。方法:收集72例稳定期精神分裂症患者,采用RBANS量表、Stroop测试、Link系列病耻感量表测量其认知功能及病耻感,后根据缺陷型精神分裂症诊断量表(SDS量表)分为缺陷型组(29例)与非缺陷型组(43例),并招募正常对照组40例,采用RBANS、Stroop测试测量其认知功能。结果:缺陷型精神分裂症患者在RBANS量表(P<0.05)及病耻感量表除教育(P>0.05)外各维度评分(P<0.05)明显高于非缺陷型精神分裂症;Stroop测试中缺陷型精神分裂症在各组测试用时明显高于非缺陷型组(P<0.05);72例精神分裂症患者斯皮尔曼相关分析提示RBANS各维度与贬低-歧视、退缩、应对、误解、不同/羞耻、情感体验、病耻感总分斯皮尔曼相关系数绝对值>0.3,呈负相关关系;Stroop测验各维度评分以色时间与贬低-歧视、不同/羞耻、情感体验、病耻感总分斯皮尔曼相关系数绝对值>0.3,字时间与除保密、教育、挑战、分离、应对外各维度斯皮尔曼相关系数绝对值>0.3,色字时间与除保密、教育、挑战、分离外各维度斯皮尔曼相关系数绝对值>0.3,以色字时间-字时间与病耻感除教育、分离维度外各维度斯皮尔曼相关系数绝对值>0.3,呈正相关关系;SDS量表评分与病耻感相关性分析提示除教育外各维度斯皮尔曼相关系数均>0.3,呈正相关关系。结论:缺陷型精神分裂症较非缺陷型精神分裂症认知功能损害及病耻感更严重;相关分析结果提示病耻感与非社会认知功能损害存在负相关关系,与阴性症状存在适度的正相关。

Objective:To explore the relationship between cognitive impairment,negative symptoms and stigma in patients with deficit schizophrenia.Methods:There were 72 patients with stable schizophrenia who were collected in the study.Their cognitive function and stigma were measured with RBANS scale,Stroop test and Link series of stigma scales.Then they were divided into deficit group(29 cases)and non-deficit group(43 cases)according to the schedule for the deficit syndrome(SDS).Besides,40 normal controls were recruited in the surrounding community,and their cognitive function was measured by RBANS scale and Stroop test.Results:The scores of all dimensions except education(P>0.05)in RBANS scale(P<0.05)and stigma scales(P<0.05)of patients with deficit schizophrenia were significantly higher than those of non-deficit schizophrenia patients.In Stroop test,the test time of deficit patients was significantly longer than that of non-deficit patients(P<0.05).Spearman correlation analysis of 72 schizophrenic patients showed that the absolute value of Spearman correlation coefficient between each dimension of RBANS and devaluation discrimination,withdrawal,coping,misunderstanding,difference/shame,emotional experience and total score of stigma was greater than 0.3,showing a negative correlation.The absolute value of Spearman correlation coefficient between color time and derogation discrimination/shame,emotional experience and total score of stigma in each dimension of Stroop test was greater than 0.3.That between word time and all dimensions except confidentiality,education,challenge,separation and response was greater than 0.3;that between color word time and all dimensions except confidentiality,education,challenge and separation was greater than 0.3,and between color word time word time and stigma was greater than 0.3 except for education and separation.These absolute values greater than 0.3 showed a positive correlation.The correlation analysis between SDS score and stigma showed that the Spearman correlation coefficients of all dimensions except education were greater than 0.3,showing a positive correlation.Conclusion:The cognitive impairment and stigma are more serious in the patients with deficit schizophrenia than in those with non-deficit schizophrenia.The results of correlation analysis suggest that there is a negative correlation between stigma and non-social cognitive impairment,and a moderate positive correlation with negative symptoms.