Medalia Alice, Thysen Julie
Department of Psychiatry, Columbia University Medical Center, New York, NY 10467, USA.
Schizophr Bull. 2008 Nov;34(6):1221-30. doi: 10.1093/schbul/sbm144. Epub 2008 Jan 16.
Insight into psychotic symptoms is typically poor in schizophrenia; however, it is not known whether insight into neurocognitive impairment is similarly impaired. Most people with schizophrenia experience cognitive dysfunction, and the deficits in attention, memory, and critical thinking have been associated with poor functional outcome. As new treatments are developed for the cognitive impairments, it will be important to know whether patients will be receptive to yet another therapy. Insight is an important factor in treatment compliance and treatment outcome; however, it is not known if patients have insight into their cognitive dysfunction. In order to assess insight into neuro cognitive dysfunction, 75 subjects were administered the Measure of Insight into Cognition-Clinician Rated, a newly created measure based on the Scale to Access the Unawareness of Mental Disorder, that assesses insight into cognitive impairment. Subjects were also administered the Brief Assessment of Cognition in Schizophrenia and Independent Living Scale-Problem Solving to objectively assess neuropsychological status and problem-solving skills needed for independent living. Results demonstrated that virtually all subjects had cognitive impairment, yet insight into their neuro cognitive symptoms was limited. This finding has potential implications for treatment programs seeking to improve cognitive functioning in schizophrenia.
在精神分裂症中,对精神病性症状的自知力通常较差;然而,对神经认知障碍的自知力是否同样受损尚不清楚。大多数精神分裂症患者存在认知功能障碍,注意力、记忆力和批判性思维方面的缺陷与功能预后不良有关。随着针对认知障碍的新疗法不断开发,了解患者是否会接受另一种治疗将很重要。自知力是治疗依从性和治疗效果的重要因素;然而,尚不清楚患者是否对其认知功能障碍有自知力。为了评估对神经认知功能障碍的自知力,对75名受试者进行了《认知自知力测量-临床医生评定》,这是一种基于《精神障碍无自知力评定量表》新创建的测量方法,用于评估对认知障碍的自知力。还对受试者进行了《精神分裂症认知简短评估》和《独立生活量表-问题解决》,以客观评估神经心理状态和独立生活所需的问题解决能力。结果表明,几乎所有受试者都有认知障碍,但对其神经认知症状的自知力有限。这一发现对旨在改善精神分裂症患者认知功能的治疗方案具有潜在意义。