Savage C R, Baer L, Keuthen N J, Brown H D, Rauch S L, Jenike M A
Department of Psychiatry, Massachusetts General Hospital, Charlestown 02129-2060, USA.
Biol Psychiatry. 1999 Apr 1;45(7):905-16. doi: 10.1016/s0006-3223(98)00278-9.
Previous neuropsychological studies of obsessive-compulsive disorder (OCD) have indicated impaired executive functioning and nonverbal memory. The extent to which impaired executive functioning impacts nonverbal memory has not been established. The current study investigated the mediating effects of organizational strategies used when copying a figure on subsequent nonverbal memory for that figure.
We examined neuropsychological performance in 20 unmedicated subjects with OCD and 20 matched normal control subjects. Subjects were administered the Rey-Osterrieth Complex Figure Test (RCFT) and neuropsychological tests assessing various aspects of executive function.
OCD subjects differed significantly from healthy control subjects in the organizational strategies used to copy the RCFT figure, and they recalled significantly less information on both immediate and delayed testing. Multiple regression analyses indicated that group differences in immediate percent recall were significantly mediated by copy organizational strategies. Further exploratory analyses indicated that organizational problems in OCD may be related to difficulties shifting mental and/or spatial set.
Immediate nonverbal memory problems in OCD subjects were mediated by impaired organizational strategies used during the initial copy of the RCFT figure. Thus, the primary deficit was one affecting executive function, which then had a secondary effect on immediate memory. These findings are consistent with current theories proposing frontal-striatal system dysfunction in OCD.
先前对强迫症（OCD）的神经心理学研究表明，执行功能和非言语记忆受损。执行功能受损对非言语记忆的影响程度尚未明确。本研究调查了在临摹一幅图形时所使用的组织策略对该图形后续非言语记忆的中介作用。
我们检测了20名未接受药物治疗的强迫症患者和20名匹配的正常对照者的神经心理学表现。对受试者进行了雷-奥斯特里思复杂图形测验（RCFT）以及评估执行功能各个方面的神经心理学测试。
强迫症患者在临摹RCFT图形时所使用的组织策略与健康对照者有显著差异，并且他们在即时和延迟测试中回忆的信息明显更少。多元回归分析表明，即时回忆百分比的组间差异显著由临摹组织策略介导。进一步的探索性分析表明，强迫症患者的组织问题可能与心理和/或空间定势转换困难有关。
强迫症患者的即时非言语记忆问题是由临摹RCFT图形最初阶段受损的组织策略介导的。因此，主要缺陷是影响执行功能的缺陷，进而对即时记忆产生次要影响。这些发现与目前提出强迫症存在额叶-纹状体系统功能障碍的理论一致。
