Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore.
Department of General Psychiatry, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore.
Psychiatry Res. 2018 May;263:54-60. doi: 10.1016/j.psychres.2018.02.025. Epub 2018 Feb 14.
Deficit syndrome of schizophrenia is a subtype of schizophrenia characterized by primary and enduring negative symptoms. This study examined the differences in neurocognitive functioning and quality of life (QOL) between deficit and non-deficit patients, and specific predictors of both clinical measures. Overall, 344 subjects (175 patients with non-deficit schizophrenia (NDSZ), 58 patients with deficit schizophrenia (DSZ) and 111 healthy controls) were evaluated on severity of psychopathology, QOL and a smaller subset of 198 subjects (104 NDSZ, 27 DSZ, 67 healthy controls) underwent neurocognitive assessments. Multivariate analyses were used to determine differences in outcomes between subject groups and predictors of clinical measures. Both DSZ and NDSZ had significantly worse QOL compared with healthy controls. DSZ had more extensive cognitive deficits compared with healthy controls and performed worse on semantic fluency task compared to NDSZ. Multiple linear regression analysis found that DSZ, shorter duration of illness were associated with poorer QOL whereas fewer years of education, lower premorbid intelligence were associated with poorer overall neurocognitive functioning. The poorer QOL, greater extent of neurocognitive deficits especially semantic fluency associated with DSZ behoves the need for greater attention during clinical evaluation and treatment planning of this subgroup of individuals with schizophrenia.
精神分裂症缺陷综合征是一种以原发性和持续性阴性症状为特征的精神分裂症亚型。本研究考察了缺陷型和非缺陷型患者之间神经认知功能和生活质量(QOL)的差异,以及这两种临床指标的具体预测因素。总体而言,对 344 名受试者(175 名非缺陷型精神分裂症患者(NDSZ)、58 名缺陷型精神分裂症患者(DSZ)和 111 名健康对照者)进行了精神病理学严重程度、QOL 评估,以及对较小的 198 名受试者(104 名 NDSZ、27 名 DSZ、67 名健康对照者)进行了神经认知评估。采用多变量分析确定了不同受试者组之间的结果差异以及临床指标的预测因素。DSZ 和 NDSZ 的 QOL 均明显差于健康对照组。与健康对照组相比,DSZ 的认知缺陷更为广泛,在语义流畅性任务上的表现也不如 NDSZ。多元线性回归分析发现,DSZ、发病时间较短与 QOL 较差相关,而受教育年限较少、病前智力较低与整体神经认知功能较差相关。DSZ 的 QOL 更差,神经认知缺陷的程度更大,特别是语义流畅性相关,这表明在对这组精神分裂症患者进行临床评估和治疗计划时,需要给予更多关注。