Heinik J, Lahav D, Drummer D, Vainer-Benaiah Z, Lin R
Margoletz Psychogeriatric Center, Ichilov Hospital, Tel-Aviv, Israel.
Int J Geriatr Psychiatry. 2000 Jul;15(7):638-43. doi: 10.1002/1099-1166(200007)15:7<638::aid-gps166>3.0.co;2-d.
The objective of this study was to compare between the quantitative and qualitative aspects of a clock drawing test in elderly schizophrenic and Alzheimer's disease (AD) patients. Three independent raters performed a retrospective analysis of the clock drawing item from the Cambridge Cognitive Examination (CAMCOG), in long-term open wards of a public psychiatric hospital and an outpatient psychogeriatric clinic. The study group comprised 21 elderly schizophrenic patients ('graduates') and 21 AD patients matched for gender and education, and cognitive impairment confirmed by a Folstein mini-mental state examination (MMSE) score of 18-23. The Clock Drawing Interpretation Scale (CDIS) was the measure used. Schizophrenic patients were significantly younger than AD patients (63.5 versus 81.3 years, p<0.0001), however, similar concerning gender, education, MMSE and CAMCOG scores. CDIS scores were not correlated with age in eight group. Inter-rater reliability was high (range 0.84-0.97). No significant differences between patient groups were found in mean CDIS total scores. A CDIS specific item analysis revealed that schizophrenic patients were significantly less impaired than AD patients on three out of 20 items: Number 7 (most symbols are aligned in a clockwise or a rightward direction). Number 8 (all symbols are totally within a closure figure), and Number 13 (numbers do not go beyond 12). Although schizophrenic patients and AD patients had similar total scores on the clock drawing test, they differed on specific test items related to spatial/planning deficit and preservation.
本研究的目的是比较老年精神分裂症患者和阿尔茨海默病（AD）患者在画钟测试中的定量和定性方面。三名独立评估者对一家公立精神病医院的长期开放病房和一家门诊老年精神科诊所中剑桥认知检查（CAMCOG）的画钟项目进行了回顾性分析。研究组包括21名老年精神分裂症患者（“患者”）和21名在性别和教育程度上匹配的AD患者，且通过福尔斯坦简易精神状态检查（MMSE）得分为18 - 23分来确认存在认知障碍。使用的测量工具是画钟解释量表（CDIS）。精神分裂症患者比AD患者显著年轻（63.5岁对81.3岁，p<0.0001），然而，在性别、教育程度、MMSE和CAMCOG评分方面相似。八组中CDIS评分与年龄均无相关性。评估者间信度较高（范围为0.84 - 0.97）。患者组间在平均CDIS总分上未发现显著差异。对CDIS特定项目的分析显示，在20个项目中的3个项目上，精神分裂症患者的受损程度明显低于AD患者：项目7（大多数符号按顺时针或向右方向排列）、项目8（所有符号完全在一个封闭图形内）和项目13（数字不超过12）。虽然精神分裂症患者和AD患者在画钟测试中的总分相似，但他们在与空间/规划缺陷和保留相关的特定测试项目上存在差异。
