Szoke Andrei, Meary Alexandre, Trandafir Anca, Bellivier Frank, Roy Isabelle, Schurhoff Franck, Leboyer Marion
INSERM, U 841, F-94000 Créteil, France.
Eur Psychiatry. 2008 Jan;23(1):20-5. doi: 10.1016/j.eurpsy.2007.10.006. Epub 2007 Dec 20.
Schizoaffective disorder could be considered as a form of schizophrenia, a form of bipolar disorder, an independent disorder or a disorder intermediate between bipolar disorder and schizophrenia, within a psychotic continuum. The study of cognitive deficits in subjects with those diagnoses could help differentiate between these possibilities.
We compared cognitive performances of schizoaffective (SZAff) subjects with those of subjects with schizophrenia (SZ), bipolar disorder with psychotic symptoms (life-time) (BDP), bipolar disorder without life-time occurrence of psychotic symptoms (BD) and normal controls (NC). We used two tests of executive functions - the Wisconsin Card Sorting Test (WCST) and the Trail-making Test (TMT) - that are known to be impaired in those disorders.
The number of perseverative errors on WCST was highest in SZ subjects and gradually decreased in SZAff, BDP and, finally in BD subjects. By contrast, SZ and SZAff subjects obtained similar scores in the TMT, as did BD and BDP patients.
These results suggest that, for some deficits, there may be a continuum between SZ, SZAff and affective disorders, whereas SZAff patients most closely resemble SZ patients for other deficits. This implies that different conceptual views about schizoaffective disorder should be seen as complementary, rather than mutually exclusive.
分裂情感性障碍可被视为精神分裂症的一种形式、双相情感障碍的一种形式、一种独立的障碍，或处于双相情感障碍和精神分裂症之间的一种障碍，存在于一个精神病性连续谱中。对患有这些诊断的受试者的认知缺陷进行研究有助于区分这些可能性。
我们比较了分裂情感性障碍（SZAff）受试者与精神分裂症（SZ）受试者、有精神病性症状的双相情感障碍（终生）（BDP）受试者、无终生精神病性症状的双相情感障碍（BD）受试者以及正常对照（NC）的认知表现。我们使用了两种执行功能测试——威斯康星卡片分类测试（WCST）和连线测验（TMT）——已知这些测试在这些障碍中会受损。
WCST上的持续性错误数量在SZ受试者中最高，在SZAff、BDP受试者中逐渐减少，最终在BD受试者中减少。相比之下，SZ和SZAff受试者在TMT中获得的分数相似，BD和BDP患者也是如此。
这些结果表明，对于某些缺陷，SZ、SZAff和情感障碍之间可能存在连续谱，而对于其他缺陷，SZAff患者与SZ患者最为相似。这意味着关于分裂情感性障碍的不同概念观点应被视为互补的，而非相互排斥的。
