Smell and Taste Clinic, Department of Otorhinolaryngology, TU, Dresden, Germany; Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
Department of Psychiatry, TU, Dresden, Germany.
Schizophr Res. 2019 Oct;212:99-106. doi: 10.1016/j.schres.2019.08.004. Epub 2019 Aug 12.
Aim Olfactory deficits are potential markers of early diagnosis, monitoring progress and predicting outcome in patients with schizophrenia and depression. We aimed to investigate differences in patterns and influencing factors of olfactory deficits between patients with acute episode of schizophrenia and major depressive episode (MDE).
Fifty-two patients with acute episode of schizophrenia, 75 patients with unipolar MDE and 199 healthy controls were included in this retrospective study. Following a structured interview, participants underwent olfactory tests (Sniffin' Sticks), assessment of psychiatric symptoms (Positive and Negative Syndrome Scale), depressive symptoms (Hamilton Depression Rating Scale), and cognitive function (color-word test and word generation test).
Both patients with schizophrenia and MDE exhibited significant olfactory deficits, and MDE patients have poorer olfactory sensitivity than schizophrenia. Patients with MDE had a higher proportion of olfactory deficits (45.3% and 28%, respectively) but a better self-awareness (21.3% and 9.6%, respectively) than patients with schizophrenia. In patients with schizophrenia, PANSS scores was positively associated with olfactory sensitivity but negatively associated with olfactory identification, and olfactory discrimination was associated with word generation. In patients with MDE, olfactory discrimination was associated with word generation and age, but not disease severity. First-episode schizophrenia group showed significantly lower threshold scores than recurrent schizophrenia group, and first-episode MDE group had significantly lower threshold scores and higher discrimination scores than the recurrent MDE group.
Patterns and modulating factors of olfactory deficits in acute episode of schizophrenia and MDE are different, their differences should be considered when using olfactory deficits as marker in clinical practice.
嗅觉缺陷可能是精神分裂症和抑郁症患者早期诊断、监测病情进展和预测预后的标志物。我们旨在研究急性精神分裂症发作和单相重度抑郁发作（MDE）患者嗅觉缺陷模式和影响因素的差异。
本回顾性研究纳入了 52 例急性精神分裂症患者、75 例单相 MDE 患者和 199 例健康对照者。在进行结构化访谈后，参与者接受了嗅觉测试（Sniffin' Sticks）、精神病症状评估（阳性和阴性综合征量表）、抑郁症状评估（汉密尔顿抑郁评定量表）和认知功能评估（颜色词测试和词语生成测试）。
精神分裂症和 MDE 患者均存在明显的嗅觉缺陷，且 MDE 患者的嗅觉敏感性较精神分裂症患者更差。MDE 患者嗅觉缺陷的比例较高（分别为 45.3%和 28%），但自我意识较好（分别为 21.3%和 9.6%）。在精神分裂症患者中，PANSS 评分与嗅觉敏感性呈正相关，与嗅觉识别呈负相关，而嗅觉辨别与词语生成有关。在 MDE 患者中，嗅觉辨别与词语生成和年龄有关，但与疾病严重程度无关。首发精神分裂症组的阈值评分明显低于复发精神分裂症组，首发 MDE 组的阈值评分和辨别评分明显低于复发 MDE 组。
急性精神分裂症发作和 MDE 患者嗅觉缺陷的模式和调节因素不同，在临床实践中应用嗅觉缺陷作为标志物时应考虑这些差异。
