Hanuszkiewicz Igor, Cechnicki Andrzej, Kalisz Aneta
Pracownia Psychiatrii Srodowiskowej Katedry Psychiatrii CM UJ.
Psychiatr Pol. 2007 Jul-Aug;41(4):539-50.
Cognitive deficits are the "primary" dysfunction in schizophrenia. They make possible a reliable prediction of the broadly understood adjustment of the psychiatric patients. The purpose of this paper is to evaluate the relation between the results of rehabilitation and the cognitive deficits among the patients diagnosed with schizophrenia.
The assessment of the cognitive deficits presented in this paper was conducted using the WCST, the Trial Making Test and a verbal fluency tests. These tests evaluated mainly executive functioning and working memory. Four indicators of the course of schizophrenia were taken into consideration: the severity of symptoms assessed by PANNS, the range of social interactions, professional functioning (readiness to be employed) and the Quality of Life self-evaluation questionnaire by Olivier. Altogether 64 patients diagnosed with schizophrenia (in accordance with the DSM-IV and ICD-10) who participated in a rehabilitation programme were assessed.
The study showed correlation between poorer verbal fluency and severity of negative symptoms, worse professional functioning, limited range of social interactions and lesser satisfaction with work, privacy level and the time spent outside home estimated by the QLQ. The poorer results of the TMT correlate with the severity of negative symptoms and the level of general psychopathology as well as with worse professional functioning. The number of correct answers in the WCST is correlated with the level of professional functioning. Persons with higher education made less perseverative errors. Persons who managed to finish the first category of the test faster are characterised by a broader social interactions network.
It was demonstrated that within the studied group of people with a long-term course of schizophrenia cognitive deficits correlate with the considered indicators of the results of rehabilitation process.
认知缺陷是精神分裂症的“主要”功能障碍。它们使得可靠预测精神病患者广义上的适应情况成为可能。本文的目的是评估被诊断为精神分裂症的患者康复结果与认知缺陷之间的关系。
本文所呈现的认知缺陷评估采用威斯康星卡片分类测验（WCST）、连线测验和语言流畅性测试。这些测试主要评估执行功能和工作记忆。考虑了精神分裂症病程的四个指标：用阳性和阴性症状量表（PANNS）评估的症状严重程度、社交互动范围、职业功能（就业准备情况）以及奥利维耶生活质量自评问卷。总共对64名参与康复项目且被诊断为精神分裂症（符合《精神疾病诊断与统计手册》第四版和《国际疾病分类》第十版）的患者进行了评估。
研究表明，较差的语言流畅性与阴性症状严重程度、较差的职业功能、有限的社交互动范围以及对工作、隐私水平和通过QLQ评估的外出时间的较低满意度之间存在相关性。连线测验较差的结果与阴性症状严重程度、总体精神病理学水平以及较差的职业功能相关。WCST中的正确答案数量与职业功能水平相关。受过高等教育的人持续性错误较少。那些能够更快完成测试第一类的人其社交互动网络更广泛。
结果表明，在患有长期精神分裂症的研究人群中，认知缺陷与康复过程结果的相关指标相关。
