Potter Anya I, Nestor Paul G
University of Massachusetts at Boston, Boston, MA, USA.
J Nerv Ment Dis. 2010 Aug;198(8):580-5. doi: 10.1097/NMD.0b013e3181ea4e43.
Intellectual decline, a key component of cognitive impairment in schizophrenia, varies considerably across individuals. To examine such cognitive heterogeneity, we applied cluster analysis of IQ and oral reading scores in 73 patients with schizophrenia. The following 3 empirically-derived subtypes emerged: intellectually compromised (42%) with similarly subaverage IQ (M = 79.90) and oral reading (M = 84.03); intellectually deteriorated (29%) with subaverage IQ (M = 86.81) but average oral reading (M = 107.71); and intellectually preserved (29%) with average IQ (M = 108.38) and oral reading (M = 104.43). Compromised and deteriorated clusters showed impairments in both executive function and memory, whereas the preserved cluster showed only reduced executive functioning. The 3 clusters also differed in symptom patterns; with intellectually compromised and intellectually deteriorated both rated with higher negative than positive symptoms, in contrast to the opposite pattern of intellectually preserved. Cluster symptom and neuropsychological profiles may help to validate empirically-derived IQ subtypes in schizophrenia.
智力衰退是精神分裂症认知障碍的一个关键组成部分，个体之间差异很大。为了研究这种认知异质性，我们对73名精神分裂症患者的智商和口头阅读分数进行了聚类分析。出现了以下3种基于实证得出的亚型：智力受损型（42%），智商（M = 79.90）和口头阅读能力（M = 84.03）同样低于平均水平；智力衰退型（29%），智商低于平均水平（M = 86.81）但口头阅读能力处于平均水平（M = 107.71）；以及智力保留型（29%），智商（M = 108.38）和口头阅读能力（M = 104.43）处于平均水平。受损型和衰退型聚类在执行功能和记忆方面均表现出损伤，而保留型聚类仅表现出执行功能下降。这3个聚类在症状模式上也有所不同；智力受损型和智力衰退型的阴性症状评分均高于阳性症状，而智力保留型则呈现相反的模式。聚类症状和神经心理学特征可能有助于验证精神分裂症中基于实证得出的智商亚型。
