Wüthrich Florian, Pavlidou Anastasia, Stegmayer Katharina, Eisenhardt Sarah, Moor Jeanne, Schäppi Lea, Vanbellingen Tim, Bohlhalter Stephan, Walther Sebastian
Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland.
Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland.
Schizophr Res. 2020 Sep;223:258-264. doi: 10.1016/j.schres.2020.08.013. Epub 2020 Sep 1.
Gestures are an important part of communication. Patients with schizophrenia present gesture deficits that tend to deteriorate in the course of the disease and hamper functional outcome. This gesture deficit has been associated with motor abnormalities, cognitive impairment, and psychotic symptoms. Unaffected, first-degree relatives of schizophrenia patients share some subclinical motor and cognitive abnormalities. We aimed to investigate, whether gesture performance changes with symptomatic improvement in patients, and to test the longitudinal performance in unaffected, first-degree relatives.
In this study, we measured gesture performance using a validated test in 33 patients, 29 first-degree relatives and 38 healthy controls. Measurements were completed shortly after admission and before discharge in patients. Performance was rated blindly by experts using video recordings of the gesture task. Additionally, we evaluated cognitive function and psychotic symptoms at both visits.
Gesture performance was poorer in relatives compared to controls and poorer in patients compared to both relatives and controls. Patients showed an improvement in psychopathology but a significant decrease in gesture performance at follow-up, while performance in the other groups remained stable. Proportional change of gesture performance correlated with change of cognitive function in patients, whereas there were no correlations with change of cognitive function in the other groups.
While symptom severity was reduced, the gesture deficit further deteriorated in schizophrenia. The finding argues for distinct processes contributing to poor nonverbal communication skills in patients, requiring novel alternative treatment efforts.
手势是交流的重要组成部分。精神分裂症患者存在手势缺陷，且在疾病过程中往往会恶化，进而妨碍功能预后。这种手势缺陷与运动异常、认知障碍及精神病性症状有关。精神分裂症患者未患病的一级亲属存在一些亚临床运动和认知异常。我们旨在研究患者的手势表现是否会随着症状改善而变化，并测试未患病的一级亲属的纵向表现。
在本研究中，我们使用一项经过验证的测试，对33例患者、29名一级亲属和38名健康对照者的手势表现进行了测量。患者在入院后不久和出院前完成测量。由专家通过手势任务的视频记录对手势表现进行盲法评分。此外，我们在两次就诊时均评估了认知功能和精神病性症状。
与对照组相比，亲属的手势表现较差；与亲属和对照组相比，患者的手势表现较差。患者的精神病理学症状有所改善，但随访时手势表现显著下降，而其他组的表现保持稳定。患者手势表现的比例变化与认知功能的变化相关，而其他组与认知功能的变化无相关性。
虽然精神分裂症患者症状严重程度降低，但手势缺陷进一步恶化。这一发现表明，导致患者非言语沟通技能差的过程不同，需要新的替代治疗方法。
