CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.
Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
Eur Arch Psychiatry Clin Neurosci. 2024 Sep;274(6):1395-1404. doi: 10.1007/s00406-024-01785-0. Epub 2024 Mar 13.
Cognitive impairment is recognized as a risk factor for suicide in schizophrenia (SZ) patients. Despite empathy being an important aspect of social cognition, the association between suicidal behavior and empathy has received little attention. We aimed to compare empathy and neurocognition in SZ patients with and without suicide attempts (SAs), and to explore the relationship between empathy, neurocognition, and clinical symptoms in SZ patients with and without SAs. Data on SAs and socio-demographic characteristics were collected from 628 chronic SZ patients. The patients' symptomatology was measured by the Positive and Negative Syndrome Scale (PANSS). Empathy and neurocognition were assessed with the Interpersonal Reactivity Index (IRI) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), respectively. Patients with SAs performed better on all IRI domains (except for Perspective Taking) and total scores. Regression results showed that negative symptoms, positive symptoms, and duration of illness were independently associated with IRI total score in patients without SAs (adjusted R = 0.048). In patients without SAs, negative symptoms, general psychopathology, education, age, and sex were independently associated with RBANS total score (adjusted R = 0.265), while in patients with SAs, education, PANSS total score, and age at onset were independently associated with RBANS total score (adjusted R = 0.456). Our results show that SZ patients with SAs may have better empathic performance than patients without SAs. In chronic SZ patients, negative and positive symptoms may have different effects on cognition in the SAs and non-SAs groups.
认知障碍被认为是精神分裂症（SZ）患者自杀的一个风险因素。尽管同理心是社会认知的一个重要方面，但自杀行为与同理心之间的关系却很少受到关注。我们旨在比较有和没有自杀企图（SA）的 SZ 患者的同理心和神经认知，并探讨有和没有 SA 的 SZ 患者的同理心、神经认知与临床症状之间的关系。从 628 名慢性 SZ 患者中收集了关于 SA 和社会人口统计学特征的数据。患者的症状通过阳性和阴性综合征量表（PANSS）进行测量。同理心和神经认知分别使用人际反应指数（IRI）和重复神经心理状态评估量表（RBANS）进行评估。有 SA 的患者在所有 IRI 领域（除观点采择外）和总分上的表现都更好。回归结果表明，在没有 SA 的患者中，阴性症状、阳性症状和疾病持续时间与 IRI 总分独立相关（调整后的 R = 0.048）。在没有 SA 的患者中，阴性症状、一般精神病学、教育、年龄和性别与 RBANS 总分独立相关（调整后的 R = 0.265），而在有 SA 的患者中，教育、PANSS 总分和发病年龄与 RBANS 总分独立相关（调整后的 R = 0.456）。我们的研究结果表明，有 SA 的 SZ 患者的同理心表现可能优于没有 SA 的患者。在慢性 SZ 患者中，阴性和阳性症状可能对 SA 和非 SA 组的认知有不同的影响。
