Lewis Ralph
Department of Psychiatry, University of Toronto, and Division of Youth Psychiatry, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ont.
J Psychiatry Neurosci. 2004 Mar;29(2):102-13.
This review examines the question of whether cognitive deficits in schizophrenia are sufficiently reliable, stable and specific to warrant inclusion in the diagnostic criteria for schizophrenia. The literature provides evidence that cognitive deficits are highly prevalent and fairly marked in adult patients with schizophrenia. Similar deficits have been found in children and adolescents with schizophrenia, and in children before they exhibit the signs and symptoms of schizophrenia. These deficits may in fact be central to the pathophysiology underlying the development of overt psychosis in schizophrenia. The deficits appear to be relatively stable across the course of the illness. They are generally more severe in schizophrenia than in affective disorders and may have a relatively specific pattern in schizophrenia. It is concluded that the evidence that cognitive deficits are a core feature of schizophrenia is sufficiently compelling to warrant inclusion of these deficits in the diagnostic criteria for schizophrenia, at least as a nonessential criterion.
本综述探讨了精神分裂症的认知缺陷是否足够可靠、稳定且具有特异性，从而有理由纳入精神分裂症的诊断标准这一问题。文献表明，认知缺陷在成年精神分裂症患者中非常普遍且相当明显。在患有精神分裂症的儿童和青少年中，以及在出现精神分裂症体征和症状之前的儿童中，也发现了类似的缺陷。实际上，这些缺陷可能是精神分裂症明显精神病性症状发展背后病理生理学的核心。这些缺陷在疾病过程中似乎相对稳定。它们在精神分裂症中通常比在情感障碍中更严重，并且在精神分裂症中可能具有相对特定的模式。得出的结论是，认知缺陷是精神分裂症核心特征的证据足够有说服力，足以将这些缺陷纳入精神分裂症的诊断标准，至少作为一项非必要标准。
