Chugunov D A, Shmilovich A A, Larina M R, Goncharenko S N, Moiseeva T V, Ryauzova E S, Fedorova E V, Bukinich A A
Pirogov Russian National Research Medical University, Moscow, Russia.
Alekseev Psychiatric Clinical Hospital No. 1 of the Moscow City Department of Health Care, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2024;124(4. Vyp. 2):64-71. doi: 10.17116/jnevro202412404264.
To establish the characteristics of clinical manifestations and cognitive tests in patients with schizophrenia, with a predominance of cognitive and negative disorders.
We examined 76 patients, 66 in the main group, 10 in the comparison group, who were treated in Psychiatric Hospital No. 1 and Psychiatric Hospital No. 4 (Moscow). Clinical-psychopathological, psychometric and statistical methods were used. Features of cognitive functioning were studied using the Frontal Assessment Battery (FAB) and the Edinburgh Cognitive and Behavioural Amyotrophic Lateral Sclerosis (ALS) Screen (ECAS). Emotional intelligence scores were assessed using the Ekman Face Emotion Recognition (EFER) test.
Patients with schizophrenia showed dominance of one of 3 types of deficit symptoms: cognitive, emotional, and volitional. Cognitive functions were significantly reduced in patients with schizophrenia when compared with the comparison group (mean FAB score (±SD) 13.44±2.97 in patients with schizophrenia vs. 16.10±1.70 in the comparison group; =4.10; <0.001). Cognitive functions were particularly reduced in patients with volitional deficit (mean EFER total score 42.40±9.0 in patients with volitional deficit vs. 47.21±633 in patients with cognitive deficit; =2.12; =0.039; mean FAB score 12.83±3.29 in patients with volitional deficit vs. 16.10±1.70 in the comparison group; =4.24; <0.001; mean ECAS score specific to ALS 78.80±9.07 in patients with volitional deficit vs. 84.50±6.71 in the comparison group; =2.18; =0.034).
The greatest contribution to the development of cognitive disorders in schizophrenia is made by dysfunction of frontal (especially) and temporal cortex. Executive functions, speech skills and verbal fluency are most severely damaged.
确定以认知和阴性症状为主的精神分裂症患者的临床表现特征及认知测试情况。
我们对在第一精神病院和第四精神病院（莫斯科）接受治疗的76例患者进行了检查，其中主要组66例，对照组10例。采用临床精神病理学、心理测量学和统计学方法。使用额叶评估量表（FAB）和爱丁堡认知与行为肌萎缩侧索硬化症（ALS）筛查量表（ECAS）研究认知功能特征。使用艾克曼面部表情识别（EFER）测试评估情商得分。
精神分裂症患者表现出三种类型的缺陷症状（认知、情感和意志）之一占主导。与对照组相比，精神分裂症患者的认知功能显著降低（精神分裂症患者的平均FAB得分（±标准差）为13.44±2.97，而对照组为16.10±1.70；t = 4.10；P < 0.001）。意志缺陷患者的认知功能尤其降低（意志缺陷患者的平均EFER总分42.40±9.0，认知缺陷患者为47.21±6.33；t = 2.12；P = 0.039；意志缺陷患者的平均FAB得分12.83±3.29，对照组为16.10±1.70；t = 4.24；P < 0.001；意志缺陷患者的ALS特异性平均ECAS得分78.80±9.07，对照组为84.50±6.71；t = 2.18；P = 0.034）。
额叶（尤其是）和颞叶皮质功能障碍对精神分裂症认知障碍的发展贡献最大。执行功能、言语技能和言语流畅性受损最为严重。
