Deng Fei, Phillips Michael R, Cai Bing, Yu Gary, Qian Min, Grivel Margaux M R, Chen Hanhui, Ouyang Xinyi, Xue Fang, Zhao Mingru, Kegeles Lawrence S, Susser Ezra S, Keshavan Matcheri S, Stone William S, Yang Lawrence H
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
University of Nottingham School of Economics (Ningbo, China), Zhejiang, China.
Psychol Med. 2021 Mar 16:1-13. doi: 10.1017/S003329172100043X.
Social cognition has not previously been assessed in treatment-naive patients with chronic schizophrenia, in patients over 60 years of age, or in patients with less than 5 years of schooling.
We revised a commonly used measure of social cognition, the Reading the Mind in the Eyes Test (RMET), by expanding the instructions, using both self-completion and interviewer-completion versions (for illiterate respondents), and classifying each test administration as 'successfully completed' or 'incomplete'. The revised instrument (RMET-CV-R) was administered to 233 treatment-naive patients with chronic schizophrenia (UT), 154 treated controls with chronic schizophrenia (TC), and 259 healthy controls (HC) from rural communities in China.
In bivariate and multivariate analyses, successful completion rates and RMET-CV-R scores (percent correct judgments about emotion exhibited in 70 presented slides) were highest in HC, intermediate in TC, and lowest in UT (adjusted completion rates, 97.0, 72.4, and 49.9%, respectively; adjusted RMET-CV-R scores, 45.4, 38.5, and 34.6%, respectively; all p < 0.02). Stratified analyses by the method of administration (self-completed v. interviewer-completed) and by education and age ('educated-younger' v. 'undereducated-older') show the same relationship between groups (i.e. NC>TC>UT), though not all differences remain statistically significant.
We find poorer social cognition in treatment-naive than in treated patients with chronic schizophrenia. The discriminant validity of RMET-CV-R in undereducated, older patients demonstrates the feasibility of administering revised versions of RMET to patients who may otherwise be considered ineligible due to education or age by changing the method of test administration and carefully assessing respondents' ability to complete the task successfully.
此前尚未在未接受过治疗的慢性精神分裂症患者、60岁以上患者或受教育年限不足5年的患者中评估社会认知。
我们对常用的社会认知测量工具——解读眼神中的心思测验（RMET）进行了修订，方法是扩展指导语，使用自我完成版和访谈者完成版（针对文盲受访者），并将每次测试管理分类为“成功完成”或“未完成”。修订后的工具（RMET-CV-R）被施用于来自中国农村社区的233名未接受过治疗的慢性精神分裂症患者（UT组）、154名接受过治疗的慢性精神分裂症对照患者（TC组）和259名健康对照者（HC组）。
在双变量和多变量分析中，成功完成率和RMET-CV-R分数（对70张呈现幻灯片中所表现情绪的正确判断百分比）在HC组中最高，在TC组中居中，在UT组中最低（调整后的完成率分别为97.0%、72.4%和49.9%；调整后的RMET-CV-R分数分别为45.4%、38.5%和34.6%；所有p<0.02）。按管理方法（自我完成版与访谈者完成版）以及按教育程度和年龄（“受过教育-较年轻”与“受教育不足-较年长”）进行的分层分析显示，各组之间存在相同的关系（即NC>TC>UT），尽管并非所有差异都具有统计学意义。
我们发现，未接受过治疗的慢性精神分裂症患者的社会认知比接受过治疗的患者差。RMET-CV-R在受教育不足的老年患者中的判别效度表明，通过改变测试管理方法并仔细评估受访者成功完成任务的能力，向那些可能因教育程度或年龄而被认为不符合条件的患者施用RMET修订版是可行的。
