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慢性精神分裂症症状与认知功能的纵向研究

Longitudinal study of symptoms and cognitive function in chronic schizophrenia.

作者信息

Hughes Catherine, Kumari Veena, Soni William, Das Mrigendra, Binneman Brendon, Drozd Sonia, O'Neil Shaun, Mathew Vallakalil, Sharma Tonmoy

机构信息

Section of Cognitive Psychopharmacology, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.

出版信息

Schizophr Res. 2003 Feb 1;59(2-3):137-46. doi: 10.1016/s0920-9964(01)00393-0.

Abstract

There is conflicting evidence of a relationship between changes in symptoms and cognitive functioning in schizophrenia. This study investigated longitudinal changes in psychopathology and cognitive functioning in chronic schizophrenia utilising three different dimensional models of symptomatology. Sixty-two patients diagnosed with DSM-IV schizophrenia or schizoaffective disorder were examined on two occasions over a period of 6 months for symptom improvement, measured by Positive and Negative Syndrome Scale (PANSS) [Kay et al., Schizophr. Bull. 13 (1987) 261]. Participants also completed a comprehensive battery of neuropsychological tasks designed to assess attention, verbal and non-verbal memory, psychomotor processing and executive/frontal functioning on both occasions. Twenty-five control subjects were assessed for comparison purposes. Severity of negative symptoms predicted poor neuropsychological performance on IQ, verbal fluency and memory measures at occasion one. However, using regression analyses, significant improvements in symptom ratings over time using two-, three- or five-dimensional models did not predict improvements in any aspect of cognitive functioning measured, except motor speed. The results do not suggest a causal relationship between the course of symptoms and neuropsychological functioning in chronic schizophrenia.

摘要

关于精神分裂症症状变化与认知功能之间的关系,证据存在冲突。本研究利用三种不同的症状维度模型,调查了慢性精神分裂症患者心理病理学和认知功能的纵向变化。62名被诊断为DSM-IV精神分裂症或分裂情感性障碍的患者在6个月的时间里接受了两次检查,以评估症状改善情况,采用阳性和阴性症状量表(PANSS)进行测量[凯等人,《精神分裂症通报》13(1987年)261]。参与者在两次检查时还完成了一系列全面的神经心理学任务,旨在评估注意力、言语和非言语记忆、心理运动处理以及执行/额叶功能。为了进行比较,对25名对照受试者进行了评估。阴性症状的严重程度在第一次检查时预测了在智商、言语流畅性和记忆测量方面神经心理学表现较差。然而,使用回归分析,随着时间的推移,使用二维、三维或五维模型在症状评分上的显著改善,除了运动速度外,并未预测所测量的认知功能任何方面的改善。结果并不表明慢性精神分裂症症状过程与神经心理学功能之间存在因果关系。

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