Seidman Larry J, Kremen William S, Koren Danny, Faraone Stephen V, Goldstein Jill M, Tsuang Ming T
Harvard Medical School Department of Psychiatry at Massachusetts Mental Health Center, and Harvard Institute of Psychiatric Epidemiology and Genetics, 74 Fenwood Road, Boston, MA 02115, USA.
Schizophr Res. 2002 Jan 1;53(1-2):31-44. doi: 10.1016/s0920-9964(01)00162-1.
Evidence for neuropsychological deficits in schizophrenia is substantial whereas evidence for the specificity of dysfunction is relatively sparse. To assess specificity, we compared neuropsychological function in patients with chronic schizophrenia, patients with chronic psychotic bipolar disorder and normal controls. Groups were comparable on age, ethnicity and expected intellectual ability (based on single word reading). Patients with schizophrenia and bipolar psychoses were also relatively similar on age at onset and number of hospitalizations. Using multivariate analyses of variance with sex and parental SES as covariates (our primary analyses), patients with schizophrenia were significantly more impaired than controls on seven of eight neuropsychological functions (all but verbal ability), and were significantly more impaired than bipolar patients on abstraction, perceptual-motor speed and vigilance. Bipolar patients were significantly impaired compared to controls on declarative verbal memory, and showed moderate-to-large effect size decrements on abstraction, perceptual-motor speed and vigilance. Results were not attenuated when IQ was controlled, which was significantly lower in patients with schizophrenia. Analyses indicated that the two psychiatric groups had similar profile patterns, but that patients with schizophrenia had a more severe impairment than patients with bipolar psychoses. Further research is required to determine whether similar mechanisms underly the neurocognitive deficits in these disorders.
精神分裂症存在神经心理学缺陷的证据确凿,而功能障碍特异性的证据相对较少。为评估特异性,我们比较了慢性精神分裂症患者、慢性精神病性双相情感障碍患者和正常对照者的神经心理学功能。三组在年龄、种族和预期智力水平(基于单字阅读)方面具有可比性。精神分裂症患者和双相情感障碍精神病患者在发病年龄和住院次数上也相对相似。以性别和父母社会经济地位作为协变量进行多变量方差分析(我们的主要分析),精神分裂症患者在八项神经心理学功能中的七项(除言语能力外的所有功能)上比对照组受损更严重,在抽象、感知运动速度和警觉性方面比双相情感障碍患者受损更严重。双相情感障碍患者与对照组相比,在陈述性言语记忆方面显著受损,在抽象、感知运动速度和警觉性方面显示出中到较大的效应量下降。在控制智商后结果并未减弱,精神分裂症患者的智商显著更低。分析表明,这两个精神疾病组具有相似的概况模式,但精神分裂症患者比双相情感障碍精神病患者受损更严重。需要进一步研究以确定这些疾病中神经认知缺陷是否有相似的潜在机制。