Penadés R, Gastó C, Boget T, Catalán R, Salamero M
Clinical Institute of Psychiatry and Psychology, Hospital Clínic i Provincial, Barcelona, Spain.
Compr Psychiatry. 2001 Jan-Feb;42(1):64-9. doi: 10.1053/comp.2001.19745.
The aim of the study was to analyze the role of clinical and neuropsychological variables in the psychosocial functioning and evolution of negative schizophrenia. We examined a sample of 49 negative schizophrenic outpatients who were pharmacologically stabilized. The subjects were evaluated clinically with the Positive and Negative Syndrome Scale (PANSS) and the Schedule for Affective Disorders and Schizophrenia (SADS), and neuropsychologically with a broad neuropsychological test battery. The correlations between all of the variables were studied and their predictive capacity assessed by linear regression methods. When the neuropsychological impairment criterion was established, we were able to distinguish two groups of patients with similar psychopathologies, but different neuropsychological and prognostic characteristics. Schizophrenic patients with neuropsychological impairment showed worse prognosis, worse evolution, and worse psychosocial adaptation than nonneuropsychologically impaired schizophrenics. Cognitive variables are statistically good predictors of evolution, prognosis, and adaptation. In conclusion, the negative syndrome of schizophrenia is neuropsychologically heterogeneous. Although negative patients present a similar clinical profile, their neuropsychological and prognostic characteristics may differ.
该研究的目的是分析临床和神经心理学变量在阴性精神分裂症的心理社会功能及病情演变中的作用。我们对49名药物治疗稳定的阴性精神分裂症门诊患者进行了研究。采用阳性和阴性症状量表(PANSS)及情感障碍和精神分裂症日程表(SADS)对受试者进行临床评估,并使用一套广泛的神经心理学测试组合对其进行神经心理学评估。研究了所有变量之间的相关性,并通过线性回归方法评估其预测能力。当确立神经心理学损害标准时,我们能够区分出两组具有相似精神病理学表现,但神经心理学和预后特征不同的患者。与无神经心理学损害的精神分裂症患者相比,有神经心理学损害的精神分裂症患者预后更差、病情演变更差且心理社会适应更差。认知变量在统计学上是病情演变、预后和适应的良好预测指标。总之,精神分裂症的阴性症状在神经心理学方面具有异质性。尽管阴性患者表现出相似的临床特征,但其神经心理学和预后特征可能不同。