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精神分裂症日常问题解决能力的神经认知及症状相关性

Neurocognitive and symptom correlates of daily problem-solving skills in schizophrenia.

作者信息

Revheim Nadine, Schechter Isaac, Kim Dongsoo, Silipo Gail, Allingham Baerbel, Butler Pamela, Javitt Daniel C

机构信息

Program in Cognitive Neuroscience and Schizophrenia, Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA.

出版信息

Schizophr Res. 2006 Apr;83(2-3):237-45. doi: 10.1016/j.schres.2005.12.849. Epub 2006 Jan 27.

Abstract

Functional outcome for individuals with schizophrenia has been associated with cognitive impairment. Deficits in attention, memory, speed of information processing and problem-solving skills affect independent functioning, vocational performance, and interpersonal functioning. This study investigated the relationship between neurocognitive functioning, clinical symptoms and daily problem-solving skills in seriously and persistently ill persons. Thirty-eight inpatients and outpatients were administered a neurocognitive battery for attention, working memory, processing speed, perceptual organization, and executive functioning; and semi-structured clinical interviews using the BPRS and SANS. Estimates of daily problem-solving skills were obtained using the relevant factor subscale from the Independent Living Scales (ILS-PB). Daily problem-solving skills were significantly correlated with negative symptoms, processing speed, verbal memory, and working memory scores. A regression model using an enter method suggests that working memory and negative symptoms are significant predictors of daily problem-solving skills and account for 73.2% of the variance. Further analyses demonstrate that daily problem-solving skills and negative symptoms were significantly different for inpatients and outpatients and significantly correlated with community status. The findings suggest the ILS-PB has utility as a proxy measure for assessing real-world functioning in schizophrenia.

摘要

精神分裂症患者的功能结局与认知障碍有关。注意力、记忆力、信息处理速度和解决问题能力的缺陷会影响独立功能、职业表现和人际功能。本研究调查了严重和持续性疾病患者的神经认知功能、临床症状与日常解决问题能力之间的关系。对38名住院患者和门诊患者进行了神经认知测试,包括注意力、工作记忆、处理速度、感知组织和执行功能;并使用简明精神病评定量表(BPRS)和阴性症状评定量表(SANS)进行半结构化临床访谈。使用独立生活量表(ILS-PB)的相关因子分量表获得日常解决问题能力的评估。日常解决问题能力与阴性症状、处理速度、言语记忆和工作记忆得分显著相关。采用逐步回归法的回归模型表明,工作记忆和阴性症状是日常解决问题能力的重要预测因素,可解释73.2%的方差。进一步分析表明,住院患者和门诊患者的日常解决问题能力和阴性症状存在显著差异,且与社区状态显著相关。研究结果表明,ILS-PB可作为评估精神分裂症患者现实世界功能的替代指标。

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