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精神分裂症的操作性诊断是否会显著影响精神障碍中的智力缺陷?

Does operational diagnosis of schizophrenia significantly impact intellectual deficits in psychotic disorders?

作者信息

Kitamura H, Shioiri T, Itoh M, Sato Y, Shichiri K, Someya T

机构信息

Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

出版信息

J Intellect Disabil Res. 2007 Oct;51(Pt 10):812-20. doi: 10.1111/j.1365-2788.2007.00964.x.

Abstract

BACKGROUND

Evidence suggests that, as a group, patients with schizophrenia have intellectual deficits that may precede the manifestation of psychotic symptoms; however, how successfully intelligence tests are able to discriminate schizophrenia from other psychotic disorders has yet to be investigated in detail.

METHODS

Using Wechsler Adult Intelligence Scale-Revised (WAIS-R) data for 55 inpatients with schizophrenia and 28 inpatients with non-schizophrenic psychotic disorders (NSPD) (schizophreniform disorder, brief psychotic disorder, delusional disorder, psychotic disorder due to a general medical condition, and psychotic disorders not otherwise specified), intelligence performance was compared between schizophrenia and NSPD and among different subtypes of schizophrenia.

RESULTS

There were no significant differences in intelligence quotient (IQ), verbal IQ (VIQ) and performance IQ (PIQ) discrepancy, and subtest scores of WAIS-R between the patients with schizophrenia and those with NSPD. These diagnostic groups were not discriminated well by any WAIS-R variables. Schizophrenia patients with prominent negative symptoms, on the other hand, had a significantly larger IQ discrepancy (VIQ > PIQ) than those without prominent negative symptoms and NSPD patients. Intelligence performance in schizophrenia did not differ with respect to diagnostic subtypes and longitudinal courses.

CONCLUSIONS

The current study failed to show diagnostic usefulness of WAIS-R in discriminating schizophrenia and other psychoses. A diagnosis of schizophrenia does not significantly impact intellectual deficits in psychotic disorders.

摘要

背景

有证据表明,作为一个群体,精神分裂症患者存在智力缺陷,这些缺陷可能在精神病性症状出现之前就已存在;然而,智力测试在区分精神分裂症与其他精神病性障碍方面的成功程度尚未得到详细研究。

方法

使用韦氏成人智力量表修订版(WAIS-R)的数据,对55名精神分裂症住院患者和28名非精神分裂症性精神病性障碍(NSPD)(精神分裂症样障碍、短暂精神病性障碍、妄想性障碍、由一般躯体疾病所致的精神病性障碍以及未另行特指的精神病性障碍)住院患者的智力表现进行比较,包括精神分裂症与NSPD之间以及精神分裂症不同亚型之间的比较。

结果

精神分裂症患者与NSPD患者在智商(IQ)、言语智商(VIQ)与操作智商(PIQ)差异以及WAIS-R的分测验分数方面均无显著差异。任何WAIS-R变量都不能很好地区分这些诊断组。另一方面,具有明显阴性症状的精神分裂症患者比没有明显阴性症状的精神分裂症患者和NSPD患者的智商差异(VIQ>PIQ)显著更大。精神分裂症患者的智力表现在诊断亚型和病程方面没有差异。

结论

当前研究未能表明WAIS-R在区分精神分裂症和其他精神病方面具有诊断价值。精神分裂症的诊断对精神病性障碍中的智力缺陷没有显著影响。

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