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动机和快感缺失而非表达能力通过认知功能影响男性精神分裂症患者的社会功能:一项结构方程模型研究。

The motivation and pleasure deficits but not expressivity affects social functioning through cognitive function in male patients with schizophrenia: A structural equation model.

机构信息

Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.

Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China; Department of Psychiatry, The Third People's Hospital of Huai'an, Huaian 223001, China.

出版信息

Asian J Psychiatr. 2023 Jul;85:103616. doi: 10.1016/j.ajp.2023.103616. Epub 2023 May 2.

Abstract

OBJECTIVE

This study aims to compare cognitive function and social functioning in male schizophrenia patients with deficit syndrome (DS) and non-DS, and to explore the associations among two different dimensions of negative symptoms (motivation and pleasure (MAP) and expressivity (EXP) deficits), cognitive function and social functioning base on a Structural Equation Model (SEM).

METHODS

The current study enrolled 161 male schizophrenia patients and 120 age- and education- matched healthy controls. The DS and non-DS group were categorized by the Chinese version of Schedule for the Deficit Syndrome (SDS). The psychotic and negative symptoms were evaluated by the Brief Psychiatric Rating Scale (BPRS) and the Brief Negative Symptoms Scale (BNSS). The Social functioning was measured by Scale of Social function in Psychosis Inpatients (SSPI). A battery of classical neurocognitive tests was used for assessing cognition including sustained vigilance/attention, cognitive flexibility, ideation fluency and visuospatial memory.

RESULTS

Our study indicated that DS patients performed worser in cognitive function and social functioning than non-DS patients. The SEM model demonstrated that MAP significantly affected social functioning through direct influence and mediation of cognitive function. However, our results found that EXP had little influence on cognitive function and social function.

CONCLUSION

Our findings provided evidence supporting that DS may represent as a subtype of schizophrenia, and the MAP factor play a pivotal role to influence the cognitive and social functioning in schizophrenia patients.

摘要

目的

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,并通过结构方程模型(SEM)探讨两种不同维度的阴性症状(动机和愉悦(MAP)和表达性(EXP)缺陷)、认知功能和社会功能之间的关联。

方法

本研究纳入了 161 名男性精神分裂症患者和 120 名年龄和教育程度匹配的健康对照者。DS 和非 DS 组根据中文版缺陷综合征时间表(SDS)进行分类。精神病和阴性症状通过简明精神病评定量表(BPRS)和简明阴性症状量表(BNSS)进行评估。社会功能通过住院精神病患者社会功能量表(SSPI)进行测量。一系列经典神经认知测试用于评估认知功能,包括持续警觉/注意力、认知灵活性、思维流畅性和视空间记忆。

结果

我们的研究表明,DS 患者的认知功能和社会功能均比非 DS 患者差。SEM 模型表明,MAP 通过直接影响和认知功能的中介作用对社会功能产生显著影响。然而,我们的结果发现,EXP 对认知功能和社会功能几乎没有影响。

结论

我们的研究结果提供了证据支持 DS 可能代表精神分裂症的一种亚型,MAP 因子在精神分裂症患者的认知和社会功能中起着关键作用。

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