Voruganti L N, Heslegrave R J, Awad A G
Department of Psychiatry, University of Toronto, Ontario.
Can J Psychiatry. 1997 Dec;42(10):1066-71. doi: 10.1177/070674379704201008.
To identify the neurocognitive correlates of positive and negative schizophrenic syndromes using a battery of information-processing measures as the principal method of evaluation.
Fifty-two treated, symptomatically stable, schizophrenic (DSM-III-R) patients and 24 age-matched, healthy volunteers were administered a computerized cognitive test battery (COGLAB). The battery included measures of preattentional, attentional, conceptual, and psychomotor performance. The patients' psychopathology was rated with the positive and negative syndromes scale (PANSS), which derived scores for positive symptoms, negative symptoms, general psychopathology, and insight.
Compared with controls, schizophrenic patients, as a group, showed significant deficits on all of the neurocognitive tasks. Impaired performance on the backward masking, span of apprehension, and Wisconsin card sorting tasks correlated significantly with negative symptoms (r = 0.27-0.40), general psychopathology (r = 0.29-0.42) and impaired insight (r = 0.34-0.52), but no clear association was found between positive symptom scores and neurocognitive deficits.
Schizophrenic patients with predominantly negative symptoms and impaired insight seem to exhibit more severe neurocognitive deficits, which lends support to the evolving concept of schizophrenia subtypes and their distinctive neurobiological mechanisms.
采用一系列信息处理测量方法作为主要评估手段，确定精神分裂症阳性和阴性综合征的神经认知关联。
对52例接受治疗、症状稳定的精神分裂症（DSM-III-R）患者和24名年龄匹配的健康志愿者进行了计算机化认知测试组合（COGLAB）。该测试组合包括对注意前、注意、概念和心理运动表现的测量。用阳性和阴性综合征量表（PANSS）对患者的精神病理学进行评分，该量表得出阳性症状、阴性症状、一般精神病理学和自知力的得分。
与对照组相比，精神分裂症患者作为一个整体，在所有神经认知任务上均表现出显著缺陷。在反向掩蔽、理解广度和威斯康星卡片分类任务上的表现受损与阴性症状（r = 0.27 - 0.40）、一般精神病理学（r = 0.29 - 0.42）和自知力受损（r = 0.34 - 0.52）显著相关，但未发现阳性症状得分与神经认知缺陷之间有明确关联。
以阴性症状和自知力受损为主的精神分裂症患者似乎表现出更严重的神经认知缺陷这支持了精神分裂症亚型及其独特神经生物学机制这一不断发展的概念。
