Kalisova L, Michalec J, Dechterenko F, Silhan P, Hyza M, Chlebovcova M, Brenova M, Bezdicek O
Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic.
Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic.
Schizophrenia (Heidelb). 2023 Jul 17;9(1):43. doi: 10.1038/s41537-023-00374-9.
Schizophrenia has a profound influence on the real-life functioning of patients. There are several factors inherent to the disease course affecting the level of psychosocial functioning. Our study focused on the impact of cognitive deficit and severity of negative symptoms (i.e., the experiential domain (avolition, asociality, and anhedonia) and the expressive domain (blunted affect and alogia)) to explore psychosocial functioning in schizophrenia. Schizophrenia patients (n = 211) were tested for the presence of cognitive impairment using the NIMH-MATRICS: Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Cattery (MCCB; MATRICS Consensus Cognitive Battery) and the extent of negative symptoms using the PANSS (PANSS; Positive and Negative Syndrome Scale-selected items). The level of psychosocial functioning was measured with the Personal and Social Performance Scale (PSP). The path analysis using three regression models was used to analyse variables influencing psychosocial functioning (PSP). One of these models analyzed influence of cognitive functioning (MCCB) and negative schizophrenia symptoms (PANSS selected items reflecting expressive and experiential deficits) as predictors and NART/CRT and disease length as confounders. R was 0.54. The direct effect of the MCCB (β = 0.09) on the PSP was suppressed by the strong effect of the negative symptoms (β = -0.64). The presence of cognitive deficits and negative symptoms in our sample of schizophrenia patients significantly influences the level of their psychosocial functioning, a key factor in remission and recovery.
精神分裂症对患者的现实生活功能有深远影响。疾病进程中有几个内在因素会影响心理社会功能水平。我们的研究聚焦于认知缺陷和阴性症状严重程度(即体验领域(意志缺乏、社交退缩和快感缺失)和表达领域(情感迟钝和言语贫乏))对精神分裂症患者心理社会功能的影响,以进行探索。使用美国国立精神卫生研究所的精神分裂症认知功能改善测量与治疗研究共识认知成套测验(MCCB;精神分裂症认知功能成套测验)对211名精神分裂症患者进行认知障碍检测,并用阳性和阴性症状量表(PANSS;阳性和阴性综合征量表所选项目)检测阴性症状的程度。心理社会功能水平用个人和社会表现量表(PSP)进行测量。使用三个回归模型的路径分析来分析影响心理社会功能(PSP)的变量。其中一个模型分析了认知功能(MCCB)和精神分裂症阴性症状(PANSS所选反映表达和体验缺陷的项目)作为预测因素以及国家成人阅读测验/标准瑞文推理测验(NART/CRT)和病程作为混杂因素的影响。决定系数R为0.54。MCCB对PSP的直接效应(β = 0.09)被阴性症状的强烈效应(β = -0.64)所抑制。在我们的精神分裂症患者样本中,认知缺陷和阴性症状的存在显著影响他们的心理社会功能水平,而心理社会功能水平是康复和痊愈的关键因素。