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患有精神分裂症的男性暴力患者的神经认知特征:一项病例对照研究。

Neurocognitive features in male patients with schizophrenia exhibiting serious violence: a case control study.

作者信息

Kashiwagi Hiroko, Kuroki Noriomi, Ikezawa Satoru, Matsushita Masateru, Ishikawa Masanori, Nakagome Kazuyuki, Hirabayashi Naotsugu, Ikeda Manabu

机构信息

Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto Japan ; National Center of Neurology and Psychiatry, Ogawa-Higashi, Kodaira, Tokyo Japan.

Tokyo Metropolitan Matsuzawa Hospital, Kamikitazawa, Setagaya-ku, Tokyo, Japan.

出版信息

Ann Gen Psychiatry. 2015 Dec 21;14:46. doi: 10.1186/s12991-015-0086-7. eCollection 2015.

Abstract

BACKGROUND

The relationship between violence and neurocognitive function in schizophrenia is unclear. We examined the backgrounds and neurocognitive functions of violent and nonviolent patients with schizophrenia to identify factors associated with serious violence.

METHODS

Thirty male patients with schizophrenia who were hospitalized after committing serious violent acts were compared with 24 hospitalized male patients with schizophrenia and no history of violence. We evaluated psychiatric symptoms using the Positive and Negative Syndrome Scale (PANSS) and neurocognitive functions using the Brief Assessment of Cognition in Schizophrenia (BACS)-Japanese version.

RESULTS

Repeated-measures analyses of variance on BACS subcomponents z-scores showed that the violent and control groups had different neuropsychological profiles at trend level (p = 0.095). Post hoc analyses of variance indicated that the violent group had significantly better working memory and executive function than the control group. In post hoc ANOVAs also controlling for the effect of the presence of substance abuse on cognitive function, violent or nonviolent group had a significant main effect on executive function but not on working memory.

CONCLUSIONS

Patient with violent or non-violent schizophrenia have distinct neuropsychological profiles. These results may help develop improved psychosocial treatments.

摘要

背景

精神分裂症患者中暴力行为与神经认知功能之间的关系尚不清楚。我们研究了暴力型和非暴力型精神分裂症患者的背景及神经认知功能,以确定与严重暴力行为相关的因素。

方法

将30名实施严重暴力行为后住院的男性精神分裂症患者与24名住院的无暴力史男性精神分裂症患者进行比较。我们使用阳性和阴性症状量表(PANSS)评估精神症状,使用精神分裂症认知功能简短评估量表(BACS)日本版评估神经认知功能。

结果

对BACS子成分z分数进行重复测量方差分析显示,暴力组和对照组在趋势水平上具有不同的神经心理学特征(p = 0.095)。事后方差分析表明,暴力组的工作记忆和执行功能显著优于对照组。在同样控制药物滥用对认知功能影响的事后方差分析中,暴力组或非暴力组对执行功能有显著的主效应,但对工作记忆没有。

结论

暴力型和非暴力型精神分裂症患者具有不同的神经心理学特征。这些结果可能有助于开发改进的社会心理治疗方法。

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