Birindelli Nadia, Montemagni Cristiana, Crivelli Barbara, Bava Irene, Mancini Irene, Rocca Paola
Riv Psichiatr. 2014 Mar-Apr;49(2):77-83. doi: 10.1708/1461.16143.
The aim of this study was to investigate cognitive functioning and insight of illness in two groups of patients during their stable phases, one with schizophrenia and one with schizoaffective disorder.
We recruited 104 consecutive outpatients, 64 with schizophrenia, 40 with schizoaffective disorder, in the period between July 2010 and July 2011. They all fulfilled formal Diagnostic and Statistical Manual of Mental disorders (DSM-IV-TR) diagnostic criteria for schizophrenia and schizoaffective disorder. Psychiatric assessment included the Clinical Global Impression Scale-Severity (CGI-S), the Positive and Negative Sindrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Global Assessment of Functioning (GAF). Insight of illness was evaluated using SUMD. Neuropsychological assessment included Winsconsin Card Sorting Test (WCST), California Verbal Learning Test (CVLT), Stroop Test and Trail Making Test (TMT). Differences between the groups were tested using Chi-square test for categorical variables and one-way analysis of variance (ANOVA) for continuous variables. All variables significantly different between the two groups of subjects were subsequently analysed using a logistic regression with a backward stepwise procedure using diagnosis (schizophrenia/schizoaffective disorder) as dependent variable.
After backward selection of variables, four variables predicted a schizoaffective disorder diagnosis: marital status, a higher number of admission, better attentive functions and awareness of specific signs or symptoms of disease. The prediction model accounted for 55% of the variance of schizoaffective disorder diagnosis.
With replication, our findings would allow higher diagnostic accuracy and have an impact on clinical decision making, in light of an amelioration of vocational functioning.
本研究旨在调查两组处于病情稳定期的患者的认知功能及对疾病的洞察力，一组为精神分裂症患者，另一组为分裂情感性障碍患者。
在2010年7月至2011年7月期间，我们连续招募了104名门诊患者，其中64名精神分裂症患者，40名分裂情感性障碍患者。他们均符合精神障碍诊断与统计手册（DSM-IV-TR）中精神分裂症和分裂情感性障碍的正式诊断标准。精神科评估包括临床总体印象量表-严重程度（CGI-S）、阳性和阴性症状量表（PANSS）、精神分裂症卡尔加里抑郁量表（CDSS）以及功能总体评估（GAF）。使用SUMD评估对疾病的洞察力。神经心理学评估包括威斯康星卡片分类测验（WCST）、加利福尼亚言语学习测验（CVLT）、斯特鲁普测验和连线测验（TMT）。对于分类变量，使用卡方检验比较两组之间的差异；对于连续变量，使用单因素方差分析（ANOVA）。随后，以诊断（精神分裂症/分裂情感性障碍）为因变量，采用向后逐步法进行逻辑回归分析，对两组受试者之间所有显著不同的变量进行分析。
经过变量的向后选择，四个变量可预测分裂情感性障碍的诊断：婚姻状况、入院次数较多、注意力功能较好以及对疾病特定体征或症状的认识。该预测模型解释了分裂情感性障碍诊断方差的55%。
通过重复研究，我们的发现将提高诊断准确性，并鉴于职业功能的改善，对临床决策产生影响。
