Wang Zixu, Ling Yuru, Wang Yu, Zhu Tingting, Gao Ju, Tang Xiaowei, Yu Miao, Zhou Chao, Xu Yanmin, Zhang Xiaobin, Zhang Xiangrong, Fang Xinyu
Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China.
Suzhou Guangji Hospital, Medical College of Soochow University, Suzhou 215008, China.
Brain Sci. 2023 Jan 23;13(2):187. doi: 10.3390/brainsci13020187.
This study aims to compare the cognitive function and social functioning in male patients with deficit syndrome (DS) and non-DS, and to explore whether cognitive function serves as a mediator in the relationship between the two factors of negative symptoms (motivation and pleasure (MAP) and expressivity (EXP) deficits, and social functioning in schizophrenia patients.
One hundred and fifty-six male patients with schizophrenia and 109 age- and education-matched normal controls were enrolled in the current study. The Chinese version of a Schedule for Deficit Syndrome (SDS) was used for DS and non-DS categorization. The Brief Psychiatric Rating Scale (BPRS) and the Brief Negative Symptoms Scale (BNSS) were used to assess psychotic and negative symptoms in patients. The Social-Adaptive Functioning Evaluation (SAFE) was adopted to evaluate patients' social functioning, and a battery of classical neurocognitive tests was used to assess cognition, including sustained vigilance/attention, cognitive flexibility, ideation fluency, and visuospatial memory.
We found that male patients with DS performed worse in all four cognitive domains and social functioning compared to non-DS patients. Both total negative symptoms and its two factors were significantly associated with all four domains of cognition and social functioning in male patients. Interestingly, our results indicate that only cognitive flexibility mediates the relationship between negative symptoms and social functioning in schizophrenia patients, but there were no differences between EXP and MAP negative factors in this model.
Our findings suggest that DS patients may represent a unique clinical subgroup of schizophrenia, and the integrated interventions targeting both negative symptoms and cognition, especially cognitive flexibility, may optimally improve functional outcomes in schizophrenia patients.
本研究旨在比较有缺陷综合征（DS）和无DS的男性精神分裂症患者的认知功能和社会功能，并探讨认知功能是否在精神分裂症患者的阴性症状（动机和快感（MAP）及表达障碍（EXP）缺陷）与社会功能这两个因素之间的关系中起中介作用。
本研究纳入了156例男性精神分裂症患者和109名年龄及教育程度匹配的正常对照。采用中文版缺陷综合征量表（SDS）对DS和非DS进行分类。使用简明精神病评定量表（BPRS）和简明阴性症状量表（BNSS）评估患者的精神病性症状和阴性症状。采用社会适应功能评估（SAFE）评估患者的社会功能，并使用一系列经典神经认知测试评估认知，包括持续警觉/注意力、认知灵活性、思维流畅性和视觉空间记忆。
我们发现，与非DS患者相比，患有DS的男性患者在所有四个认知领域和社会功能方面表现更差。男性患者的总阴性症状及其两个因素均与认知和社会功能的所有四个领域显著相关。有趣的是，我们的结果表明，只有认知灵活性在精神分裂症患者的阴性症状与社会功能之间的关系中起中介作用，但在该模型中EXP和MAP阴性因素之间没有差异。
我们的研究结果表明，DS患者可能代表精神分裂症的一个独特临床亚组，针对阴性症状和认知，尤其是认知灵活性的综合干预可能会最佳地改善精神分裂症患者的功能结局。
