Stip E, Lussier I, Lalonde P, Luyet A, Fabian J
Centre de Recherche Fernard-Seguin, Hôpital L.H. Lafontaine, Département de psychiatrie, Université de Montréal, Québec.
Encephale. 1999 May-Jun;25(3):260-4.
The aim of this study was to examine selective attention in patients with chronic and refractory schizophrenia who had been exposed for six months to atypical neuroleptic medications: risperidone or clozapine.
17 patients satisfying DSM III-R criteria for schizophrenia were assessed according to BPRS and PANSS and abnormal involuntary movements to ESRS. Selective attention tasks were performed before treatment with risperidone or clozapine and at two times during the treatment (6 weeks, T1, and 24 weeks, T2). Patients' performance data were compared to data from a group of general population at T1. Selective attention refers to the ability to discriminate relevant information from irrelevant one. This was measured by a visual search task. Subjects had to search for a target specified by a conjunction of features (color and shape). The target was a black X, while the distracters were white X's, black O's and white O's. The stimuli were displayed on a Macintosh SE computer. A two-button response box was used for response production and the experiment was run in a dimly lit room. A white-fixation stimulus was shown at the center of the display screen between trials. The number of stimuli displayed on a single trial was 1, 4, 7 or 10. The median RTs and error rates of subjects were computed for each factor (target presence and number of stimuli).
A Group X Number of items X Presence of target ANOVA applied on median correct RTs revealed a significant Group X Presence interaction [F(1,176) = 60.433, p < .0001]. Performances improved with the time (F2, p < .01). Correlations were found between positive score on PANSS and performance on selective attention (r39 = -.391).
Atypical neuroleptic do not have a deleterious effect on selective attention but a favorable effect on the schizophrenic patients' performance.
本研究的目的是考察长期服用非典型抗精神病药物（利培酮或氯氮平，为期6个月）的慢性难治性精神分裂症患者的选择性注意力。
根据简明精神病评定量表（BPRS）、阳性和阴性症状量表（PANSS）以及异常不自主运动量表（ESRS）对17例符合精神分裂症DSM III-R标准的患者进行评估。在使用利培酮或氯氮平治疗前以及治疗期间的两个时间点（6周，T1；24周，T2）进行选择性注意力任务。将患者的表现数据与T1时一组普通人群的数据进行比较。选择性注意力是指从无关信息中辨别相关信息的能力。这通过视觉搜索任务来测量。受试者必须搜索由特征组合（颜色和形状）指定的目标。目标是黑色的X，而干扰项是白色的X、黑色的O和白色的O。刺激物显示在Macintosh SE计算机上。使用双按钮反应盒进行反应，实验在光线昏暗的房间里进行。试验之间，在显示屏中心显示白色固定刺激物。单次试验显示的刺激物数量为1、4、7或10。计算每个因素（目标存在和刺激物数量）下受试者的中位反应时间（RTs）和错误率。
对中位正确RTs应用组×项目数量×目标存在的方差分析显示，组×目标存在存在显著交互作用[F(1,176) = 60.433，p <.0001]。表现随时间改善（F2，p <.01）。发现PANSS阳性评分与选择性注意力表现之间存在相关性（r39 = -.391）。
非典型抗精神病药物对选择性注意力没有有害影响，反而对精神分裂症患者的表现有积极影响。
