Klingberg Stefan, Wittorf Andreas, Wiedemann Georg
Department of Psychiatry and Psychotherapy, University of Tuebingen, Osianderstr. 24, 72076, Tuebingen, Germany.
Eur Arch Psychiatry Clin Neurosci. 2006 Dec;256(8):532-40. doi: 10.1007/s00406-006-0704-0. Epub 2006 Dec 12.
Cognitive deficits are increasingly considered as essential in schizophrenic disorders. Positive symptoms and cognitive deficits have been found to be independent, whereas negative symptoms show only weak correlations to cognitive impairment. However, the relationship to a third symptom dimension, disorganization, is yet unclear. In a sample of n = 151 schizophrenia inpatients (DSM-IV/SCID) we assessed cognitive impairment using a comprehensive neuropsychological test battery and symptoms of schizophrenia applying the Positive and Negative Syndrome Scale (PANSS). Factor analyses resulted in three neuropsychological (attention, memory, abstraction) and five symptom factor scores (negative, impulsiveness, positive, disorganization, depression). The disorganization factor did not correlate significantly with any of the neuropsychological factor scores. Even after controlling for different demographic and clinical variables partial correlation coefficients did not reach a significant level. Thus, we could not confirm the previously reported associations between disorganization and measures of cognitive impairment. Despite a considerable conceptual overlap between interview based symptom ratings and classic neuropsychological tests the empirical association is limited. Our results suggest that disorganization and cognitive impairment represent different symptom dimensions.
认知缺陷在精神分裂症中日益被视为至关重要的因素。研究发现,阳性症状和认知缺陷是相互独立的,而阴性症状与认知障碍仅有微弱的相关性。然而,与第三个症状维度——紊乱的关系尚不清楚。在一个包含151名精神分裂症住院患者(依据DSM-IV/SCID诊断)的样本中,我们使用一套全面的神经心理测试组合评估认知障碍,并运用阳性和阴性症状量表(PANSS)评估精神分裂症症状。因子分析得出了三个神经心理因子得分(注意力、记忆力、抽象能力)和五个症状因子得分(阴性、冲动性、阳性、紊乱、抑郁)。紊乱因子与任何神经心理因子得分均无显著相关性。即便在控制了不同的人口统计学和临床变量后,偏相关系数仍未达到显著水平。因此,我们无法证实先前报道的紊乱与认知障碍测量指标之间的关联。尽管基于访谈的症状评定与经典神经心理测试之间存在相当大的概念重叠,但实证关联却很有限。我们的研究结果表明,紊乱和认知障碍代表了不同的症状维度。