Dibben C R M, Rice C, Laws K, McKenna P J
Fulbourn Hospital, Cambridge, UK.
Psychol Med. 2009 Mar;39(3):381-92. doi: 10.1017/S0033291708003887. Epub 2008 Jun 30.
A key neuropsychological proposal in schizophrenia is that negative and disorganization symptoms are associated with different patterns of impairment on executive tasks.
Studies reporting correlations between positive, negative or disorganization symptoms and any type of executive test were meta-analysed. The influence of moderating factors was also examined, including age, treatment and stage of illness and whether symptoms were relapsing or persistent. The magnitudes of the correlations were compared with those for general intellectual impairment.
Pooled correlations between executive impairment and both negative symptoms and disorganization were significant in the small-to-moderate range. That for positive symptoms ('reality distortion'), however, was close to zero. The pattern of correlations among different executive tests differed significantly for negative symptoms and disorganization. Patients with stable clinical pictures showed significantly higher correlations with executive impairment than those with relapsing and remitting illnesses. Both negative symptoms and disorganization also correlated significantly with general intellectual function as indexed by current IQ.
Meta-analysis supports the view that negative symptoms and disorganization are associated with partially dissociable patterns of executive impairment. However, co-existent general intellectual impairment has been an important confounding factor in the studies to date.
精神分裂症的一个关键神经心理学观点是，阴性症状和紊乱症状与执行任务的不同损伤模式相关。
对报告阳性、阴性或紊乱症状与任何类型执行测试之间相关性的研究进行荟萃分析。还检查了调节因素的影响，包括年龄、治疗和疾病阶段以及症状是复发还是持续。将相关性的大小与一般智力损伤的相关性大小进行比较。
执行功能损伤与阴性症状和紊乱症状之间的合并相关性在小到中等范围内显著。然而，阳性症状（“现实扭曲”）的相关性接近于零。不同执行测试之间的相关性模式在阴性症状和紊乱症状方面有显著差异。临床症状稳定的患者与执行功能损伤的相关性显著高于病情复发和缓解的患者。阴性症状和紊乱症状也与当前智商所反映的一般智力功能显著相关。
荟萃分析支持阴性症状和紊乱症状与部分可分离的执行功能损伤模式相关的观点。然而，迄今为止，并存的一般智力损伤一直是研究中的一个重要混杂因素。
