Fossati P, Amar G, Raoux N, Ergis A M, Allilaire J F
Department of Psychiatry, Salpétriere Hospital, Paris, France.
Psychiatry Res. 1999 Dec 27;89(3):171-87. doi: 10.1016/s0165-1781(99)00110-9.
Although neuropsychological studies have consistently reported executive deficits in schizophrenia, studies of executive functions in depression have produced equivocal results. The aim of this study was to examine the profile and the specificity of the executive impairment and its association with memory performance in young patients with unipolar depression. We compared patients with depression to normal control subjects and schizophrenics. Twenty young inpatients with unipolar depression, 14 schizophrenics and 20 age-, education- and IQ-matched control subjects were assessed with a neuropsychological battery including: (1) verbal memory task; (2) frontal tasks (WCST, Cognitive Estimate, Verbal fluency, verbal and visuo-spatial span) and a new complex sorting test (Delis test). Depressed patients and schizophrenics exhibited executive deficits. Unlike schizophrenics, depressed patients did not show memory impairment. Deficits in several 'higher-level' functions combined to produce executive impairments in patients with depression including complex integration for concept formation, spontaneous cognitive flexibility and initiation ability. Impaired functions in schizophrenia and in depressed patients were similar but were differently related to clinical variables. The pattern of memory failure in our schizophrenics is believed to reflect retrieval and encoding deficits. Our findings highlight the heterogeneity of skills grouped under the term 'executive functions' that are vulnerable in depression or schizophrenia.
尽管神经心理学研究一直报告精神分裂症存在执行功能缺陷，但关于抑郁症执行功能的研究结果却并不一致。本研究的目的是检查单相抑郁症年轻患者执行功能损害的特征、特异性及其与记忆表现的关联。我们将抑郁症患者与正常对照受试者及精神分裂症患者进行了比较。对20名单相抑郁症年轻住院患者、14名精神分裂症患者以及20名年龄、教育程度和智商匹配的对照受试者进行了神经心理测验，包括：（1）言语记忆任务；（2）额叶任务（威斯康星卡片分类测验、认知估计、言语流畅性、言语和视觉空间广度）以及一项新的复杂分类测试（德利什测试）。抑郁症患者和精神分裂症患者均表现出执行功能缺陷。与精神分裂症患者不同，抑郁症患者未表现出记忆损害。多种“高级”功能缺陷共同导致抑郁症患者出现执行功能损害，包括概念形成的复杂整合、自发认知灵活性和启动能力。精神分裂症患者和抑郁症患者受损的功能相似，但与临床变量的关系不同。我们的精神分裂症患者的记忆衰退模式被认为反映了检索和编码缺陷。我们的研究结果突出了归类于“执行功能”这一术语下的技能的异质性，这些技能在抑郁症或精神分裂症中易受影响。
