Department of Psychiatry and Psychotherapy, Philipps University of Marburg, Marburg, Germany.
Center for Mind, Brain and Behaviour, University of Marburg, Marburg, Germany.
Eur Arch Psychiatry Clin Neurosci. 2022 Apr;272(3):395-401. doi: 10.1007/s00406-021-01263-x. Epub 2021 May 7.
Formal thought disorders (FTD) are a hallmark diagnostic feature of schizophrenia (SZ) and (bipolar) mania (MA). FTD can be separated into positive (pFTD) and negative dimensions. It is unclear whether there are differences in pFTD on a single symptom level between acutely ill patients with SZ and MA, which cannot be attributed to cognitive impairment. We compared single pFTD symptoms in two groups of acutely ill patients with ICD-10 bipolar mania and schizophrenia, closely matched for age, sex, pFTD TALD score, verbal IQ and neuropsychological test performance (executive function, verbal fluency, attention, and working memory). SZ patients had higher severity of the TALD symptoms "perseverations" and "poverty of content of speech" than those with MA (Mann-Whitney U, significant, Bonferroni corrected). Speech in acute SZ patients differs from MA in that it conveys little information and adheres to previously mentioned ideas and topics. Matching for confounding variables, such as IQ and cognition, is important when comparing patients with different diagnoses.
Formal thought disorders (FTD) 是精神分裂症 (SZ) 和 (双相) 躁狂症 (MA) 的主要诊断特征。FTD 可分为阳性 (pFTD) 和阴性维度。目前尚不清楚急性发作的 SZ 和 MA 患者之间是否存在单一症状水平上的 pFTD 差异,而这些差异不能归因于认知障碍。我们比较了两组急性发作的 ICD-10 双相躁狂症和精神分裂症患者的单个 pFTD 症状,这些患者在年龄、性别、pFTD TALD 评分、言语智商和神经心理学测试表现(执行功能、言语流畅性、注意力和工作记忆)方面进行了密切匹配。与 MA 患者相比,SZ 患者的 TALD 症状“持续”和“言语内容贫乏”更为严重(Mann-Whitney U,显著,Bonferroni 校正)。急性 SZ 患者的言语与 MA 不同,因为它传达的信息量很少,并且坚持之前提到的想法和主题。当比较不同诊断的患者时,匹配 IQ 和认知等混杂变量很重要。