Frith C
Wellcome Department of Cognitive Neurology, Institute of Neurology, London, UK.
Br Med Bull. 1996 Jul;52(3):618-26. doi: 10.1093/oxfordjournals.bmb.a011571.
The diagnosis of schizophrenia is largely based on reports of bizarre experiences such as having alien thoughts inserted into one's mind. Many patients with this diagnosis show a marked intellectual decline and particular problems with tasks involving certain kinds of memory or requiring mental flexibility. Similar patterns of performance can be seen in patients with damage in the prefrontal cortex. However, patients with schizophrenia show a very varied pattern of impairments relating to their current mental state. Chronic patients with negative features, such as poverty of speech, are most likely to show poor test performance, while the presence of severe hallucinations and delusions need not be associated with any impairment. A cognitive approach suggests that hallucinations and delusions result from the patient attributing his own actions to an external agency. This error is due to an inability to distinguish between external events and perceptual changes caused by his own actions. The basis of this failure could be a functional disconnection between frontal brain areas concerned with action and posterior areas concerned with perception.
精神分裂症的诊断很大程度上基于对怪异经历的报告，比如脑海中被植入外来想法。许多被诊断为此病的患者表现出明显的智力衰退，在涉及某些类型记忆或需要思维灵活性的任务上存在特殊问题。前额叶皮质受损的患者也会出现类似的表现模式。然而，精神分裂症患者根据其当前精神状态会呈现出非常多样的损伤模式。具有诸如言语贫乏等阴性症状的慢性患者最有可能在测试中表现不佳，而严重幻觉和妄想的存在不一定与任何损伤相关。一种认知方法认为，幻觉和妄想是患者将自己的行为归因于外部主体所致。这种错误是由于无法区分外部事件和由自身行为引起的感知变化。这种失败的根源可能是负责行动的额叶脑区与负责感知的后部脑区之间的功能失联。
