Rady Ahmed, Elsheshai Adel, Abou El Wafa Heba, Elkholy Osama
Department of Psychiatry, Alexandria University, P.O. Box 518, Alexandria 21511, Egypt.
ISRN Psychiatry. 2012 Jan 23;2012:373748. doi: 10.5402/2012/373748. Print 2012.
Background. Differentiating between schizophrenia and major depression with psychotic features often reveals diagnostic dilemma. Both share psychotic features and severe impairment in occupational functions. Severe psychomotor retardation, not uncommon in psychotic depression, may simulate negative symptoms of schizophrenia. Our work aims at utilizing Wisconsin Card Sorting Test (WCST) performance as a potential differentiating neurocognitive tool. Subjects and Methods. 60 patients were recruited randomly from the outpatient service at Alexandria University Hospital: 30 patients with schizophrenia and 30 patients with chronic psychotic depression. They were subjected to Clinical Global Impression for Severity (CGI-S) scale and Wisconsin Card Sorting Test (WCST) 128 card computerized version. Results. Both groups were balanced in terms of gender distribution, severity and duration of illness. The study compared all parameters of WCST. Only perseverative errors showed mild significant difference (P < 0.05) that disappeared when applying Bonferroni adaptation, setting significance level at 0.01 instead of 0.05. Conclusion. Performance on WCST is similar in schizophrenia and severe depression with psychotic features in most of the measured parameters and hence could not serve as a supplementary tool differentiating between both diagnoses in our study.
背景。区分精神分裂症和伴有精神病性特征的重度抑郁症往往会带来诊断难题。两者都具有精神病性特征且职业功能严重受损。严重的精神运动迟缓在精神病性抑郁症中并不罕见，可能会模拟精神分裂症的阴性症状。我们的研究旨在将威斯康星卡片分类测验（WCST）表现作为一种潜在的鉴别神经认知工具。
对象与方法。从亚历山大大学医院门诊随机招募60名患者：30名精神分裂症患者和30名慢性精神病性抑郁症患者。他们接受了临床总体印象严重程度（CGI-S）量表和威斯康星卡片分类测验（WCST）128张卡片计算机化版本的测试。
结果。两组在性别分布、疾病严重程度和病程方面均衡。该研究比较了WCST的所有参数。只有持续性错误显示出轻微的显著差异（P < 0.05），当应用邦费罗尼校正将显著性水平设定为0.01而非0.05时，该差异消失。
结论。在大多数测量参数中，精神分裂症和伴有精神病性特征的重度抑郁症患者的WCST表现相似，因此在我们的研究中，WCST不能作为区分这两种诊断的辅助工具。
