Heaton R, Paulsen J S, McAdams L A, Kuck J, Zisook S, Braff D, Harris J, Jeste D V
Department of Psychiatry, University of California, San Diego.
Arch Gen Psychiatry. 1994 Jun;51(6):469-76. doi: 10.1001/archpsyc.1994.03950060033003.
We sought to determine whether neuropsychological impairment in schizophrenia is related to current age, age at onset, or duration of illness, and whether the pattern of such impairment can be distinguished from that caused by progressive dementias of Alzheimer's type. We administered a comprehensive neuropsychological test battery to a normal control group (n = 38), a group of ambulatory patients with Alzheimer's disease (n = 42), and three ambulatory schizophrenic groups: early onset-young (n = 85), early onset-old (n = 35), and late onset (n = 22). Tests were grouped and analyzed according to eight major ability areas, and published procedures were used to remove the expected effects of normal aging.
The three schizophrenic groups were found to be neuropsychologically similar to one another and different from normal controls and patients with Alzheimer's disease. There were no significant differences among the schizophrenic groups in level or pattern of neuropsychological functioning. Patients with Alzheimer's disease demonstrated less efficient learning and particularly more rapid forgetting than did the other groups.
These findings suggest that neuropsychological impairment in schizophrenia is unrelated to current age, age at onset, or duration of illness. The study further suggests that the encephalopathy associated with schizophrenia is essentially nonprogressive and produces a pattern of deficits that is different from that seen in progressive cortical dementias.
我们试图确定精神分裂症患者的神经心理损害是否与当前年龄、起病年龄或病程相关,以及这种损害模式是否能与阿尔茨海默病类型的进行性痴呆所导致的模式相区分。我们对一个正常对照组(n = 38)、一组非卧床阿尔茨海默病患者(n = 42)以及三个非卧床精神分裂症组进行了全面的神经心理测试:早发-青年组(n = 85)、早发-老年组(n = 35)和晚发组(n = 22)。测试根据八个主要能力领域进行分组和分析,并采用已发表的程序来消除正常衰老的预期影响。
发现三个精神分裂症组在神经心理方面彼此相似,且与正常对照组和阿尔茨海默病患者不同。精神分裂症组在神经心理功能水平或模式上没有显著差异。与其他组相比,阿尔茨海默病患者的学习效率较低,尤其是遗忘速度更快。
这些发现表明,精神分裂症患者的神经心理损害与当前年龄、起病年龄或病程无关。该研究进一步表明,与精神分裂症相关的脑病本质上是非进行性的,并且产生的缺陷模式与进行性皮质痴呆中所见的不同。