在中国，精神分裂症的最佳神经心理学测试组合是什么？
What is the optimal neuropsychological test battery for schizophrenia in China?
机构信息
Peking University Sixth Hospital, Beijing, China; Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China; The National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), Beijing, China.
The Medical Psychological Research Center, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
出版信息
Schizophr Res. 2019 Jun;208:317-323. doi: 10.1016/j.schres.2019.01.034. Epub 2019 Feb 1.
BACKGROUND
The MATRICS consensus cognitive battery (MCCB) has been widely used to evaluate cognitive deficits in schizophrenia (SCZ), however, no study has formally examined the validity of the MCCB in Chinese SCZ. This study compared Chinese SCZ patients with healthy Chinese controls on the MCCB and some additional neurocognitive tests to determine if the Chinese MCCB is an optimal battery to assess the cognitive deficits in Chinese SCZ patients.
METHOD
The study enrolled and examined 230 patients met DSM-IV criteria for SCZ and 656 healthy controls matched for gender, age and education. Besides the MCCB, we also included some additional neurocognitive tests that have been widely used in patients with schizophrenia. We selected MCCB and non-MCCB tests with large effect size, to assemble a new "optimal battery" and compared its performance with that of the standard MCCB.
RESULTS
Comparing the putative "optimal" battery with the original MCCB, more patients with SCZ were identified as cognitively impaired according to the criteria of GDS ≥ 0.50 for the optimal battery (166 vs 135, or 72.2% vs 58.7%). The rate of cognitive impairment according to MCCB GDS in patients with SCZ who were currently working, ever worked and never worked are 45.5%, 61.6% and 70.8% (p = 0.051), whereas the optimal battery GDS showed 56.4%, 74.8%, 91.7% (p = 0.003), respectively.
CONCLUSIONS
Our study needs validation with independent samples but suggests that the current "optimal" cognitive battery could be more sensitive than the widely used MCCB in detecting SCZ related cognitive impairment in China.
背景
MATRICS 共识认知成套测验（MCCB）已被广泛用于评估精神分裂症（SCZ）患者的认知缺陷，但尚无研究正式检验 MCCB 在中国人 SCZ 中的有效性。本研究在 MCCB 及其他一些神经认知测试的基础上，比较了中国 SCZ 患者与健康对照者的认知功能，以确定中国 MCCB 是否是评估中国 SCZ 患者认知缺陷的最佳成套测验。
方法
本研究共纳入 230 名符合 DSM-IV 精神分裂症诊断标准的患者和 656 名年龄、性别和受教育程度相匹配的健康对照者。除 MCCB 外，我们还纳入了一些广泛应用于精神分裂症患者的其他神经认知测试。我们选择 MCCB 和非 MCCB 中具有较大效应量的测试，组成一个新的“最佳成套测验”，并比较其与标准 MCCB 的性能。
结果
与原始 MCCB 相比，根据“最佳”成套测验的 GDS≥0.50 标准，更多的 SCZ 患者被确定为认知受损（166 例 vs 135 例，72.2% vs 58.7%）。当前、曾经、从未工作的 SCZ 患者根据 MCCB GDS 诊断为认知障碍的比例分别为 45.5%、61.6%和 70.8%（p=0.051），而根据“最佳”成套测验的 GDS 则分别为 56.4%、74.8%和 91.7%（p=0.003）。
结论
本研究需要用独立样本进行验证，但提示目前的“最佳”认知成套测验在中国可能比广泛使用的 MCCB 更能敏感地检测到 SCZ 相关的认知损害。
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