Cascella Nicola G, Testa S Marc, Meyer Stephen M, Rao Vani A, Diaz-Asper Catherine M, Pearlson Godfrey D, Schretlen David J
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 144, Baltimore, MD 21287, United States.
J Psychiatr Res. 2008 Sep;42(11):930-7. doi: 10.1016/j.jpsychires.2007.10.002. Epub 2007 Nov 19.
This study aimed to assess the severity and specificity of cognitive impairments that affect individuals with deficit versus non-deficit schizophrenia. We compared 26 patients with the deficit subtype of schizophrenia (SZ-D) and 79 with non-deficit schizophrenia (SZ-ND) to 316 healthy adults (NC). All study participants completed a battery with 19 individual cognitive measures. After adjusting their test performance for age, sex, race, education and estimated premorbid IQ, we derived regression-based T-scores for each measure and the six derived cognitive domains including attention, psychomotor speed, executive function, verbal fluency, visual memory, and verbal memory. Multivariate analyses of variance revealed significant group effects for every individual measure and domain of cognitive functioning (all ps<0.001). Post hoc comparisons revealed that patients with SZ-D performed significantly worse than NCs in every cognitive domain. They also produced lower scores than the SZ-ND group in every domain, but only the difference for verbal fluency reached statistical significance. The correlations of the effect sizes shown by the SZ-D and SZ-ND patients were of intermediate magnitude for the individual tests (r=0.56, p<0.01) and higher, but not statistically significant for the cognitive domains (r=0.79, p=0.06). Patients with SZ-D demonstrate cognitive deficits that are both common and distinct from those shown by patients with SZ-ND. Their impairment of verbal fluency is consistent with the observation that poverty of speech is a clinically significant feature of patients with SZ-D.
本研究旨在评估影响有缺陷型与无缺陷型精神分裂症患者的认知障碍的严重程度和特异性。我们将26例缺陷型精神分裂症（SZ-D）患者和79例无缺陷型精神分裂症（SZ-ND）患者与316名健康成年人（NC）进行了比较。所有研究参与者都完成了一套包含19项个体认知测量的测试。在对他们的测试成绩进行年龄、性别、种族、教育程度和预估病前智商的调整后，我们得出了每项测量以及包括注意力、心理运动速度、执行功能、语言流畅性、视觉记忆和语言记忆在内的六个衍生认知领域基于回归的T分数。多变量方差分析显示，在认知功能的每项个体测量和领域中均存在显著的组间效应（所有p<0.001）。事后比较显示，SZ-D患者在每个认知领域的表现均显著差于NC组。他们在每个领域的得分也低于SZ-ND组，但只有语言流畅性方面的差异达到统计学显著性。SZ-D和SZ-ND患者所显示的效应大小的相关性在个体测试中为中等程度（r=0.56，p<0.01），在认知领域中更高，但无统计学显著性（r=0.79，p=0.06）。SZ-D患者表现出的认知缺陷既与SZ-ND患者的缺陷有共同之处，又有所不同。他们的语言流畅性受损与言语贫乏是SZ-D患者的一个临床显著特征这一观察结果相一致。
