精神活动功能问卷的应用——阿尔茨海默病人与老年慢性精神分裂症病人的对照

目的 了解老年慢性精神分裂症患者的社会生活能力,并与Alzheimer病(AD)患者比较。方法 用pfeffer精神活动功能问卷(FAQ)对85例住院老年慢性精神分裂症患者与43例AD病人的社会生活能力进行调查。结果 老年慢性精神分裂症患者的社会生活能力减退亦相当严重。结论 在制定精神分裂症的康复措施与疗效评定时,不仅要注意精神症状的改善,还要注意对患者社会生活能力的观察与评估。     

MCCB测定首发精神分裂症患者及其生物学父母存在认知功能障碍

目的:精神分裂症的认知特征可能受到其生物学父母认知模式的影响.研究旨在描绘精神分裂症患者与其父母之间的功能失调的认知模式.方法:采用认知功能成套测验共识版(MCCB,一种新的测量工具)评估29例首发精神分裂症(符合ICD-10精神分裂症诊断标准,年龄17-45岁),58例精神分裂症患者的生物学父母(年龄40-70岁)和46例健康对照(年龄40-70岁)的认知功能,以探讨精神分裂症患者及其生物学父母之间的认知功能障碍之间的关系.所有数据使用SPSS18.0统计软件进行分析.结果:1)男性精神分裂症患者与其父亲相比在MCCB认知功能测定的6个维度有明显认知缺陷(除社会认知功能外).女性患者的工作记忆和问题推理能力都低于其母亲.2)患者父亲和健康对照组之间的工作记忆和推理问题也存在显著差异.3)与健康对照组相比,患者母亲在问题推理方面没有明显的差异,但视觉记忆有异常.结论:首发精神分裂症患者及其生物学父母在6个维度存在认知功能障碍.患者父母在工作记忆、问题推理和视觉记忆等方面也存在明显功能障碍.仍需深入研究以揭示首发精神分裂症及其生物学父母存在认知功能障碍的潜在机制.     

精神分裂症患者共情能力及相关因素分析

目的 通过比较住院精神分裂症患者治疗前后共情缺陷、社会功能和精神症状的差异,探讨共情能力的相关因素及药物治疗对共情能力的影响。方法 对60例（男30例,女30例）住院精神分裂症患者予新型抗精神病药物治疗3个月,采用人际反应指针量表（IRI—C）、阳性和阴性症状评定量表（PANSS）及个体和社会功能量表（PSP）,分别对患者治疗前后的共情水平、精神症状、社会功能进行评定,比较各项测量指标前后的变化,并通过各测量指标治疗后减分率的相关分析,探讨精神分裂症患者共情能力、临床症状以及社会功能的关系,以及药物治疗对共情能力的影响。结果 精神分裂症患者予新型抗精神病药治疗3个月后,共情能力、精神症状、社会功能均有所改善。治疗前后各项评分减分率进行Pearson相关分析显示,精神分裂症患者的共情能力与阴性症状呈负相关,与社会功能呈正相关。结论 非经典抗精神病药物治疗可改善共情能力、精神症状和社会功能,精神分裂症患者的阴性症状随着共情能力的改善而改善。     

精神分裂症患者危险行为影响因素的研究进展

精神障碍中精神分裂症患者发生危险行为的风险性高,其危险行为常常威胁到社会、家 庭、医护人员及其自身的人身和财产安全,影响社会和谐和安全稳定,已成为迫切需要解决的社会问题。 现从生物学、心理学、社会学角度对精神分裂症患者危险行为影响因素的研究进展进行综述。     

护理干预对精神分裂症患者社会功能的影响

目的探讨护理干预对精神分裂症患者社会功能的影响。方法将120例精神分裂症患者随机分为研究组和对照组各60例。研究组在不同病期制定康复训练计划,实施护理干预,对照组不进行干预。2组患者分别于入组时、干预6个月末采用生活能力量表(ADL)、社会功能缺陷量表(SDSS)对社会功能评估。结果干预组患者ADL的躯体生活自理能力和工具性日常生活能力显著高于对照组(P0.01),SDSS的社会功能改善显著高于对照组(P0.01)。结论护理干预有利增强患者自我照顾能力,减缓精神分裂症患者的功能衰退,促进康复。     

精神分裂症患者婚姻状况与生活质量的关系

目的：探讨社区已婚精神分裂症患者婚姻状况对生活质量的影响。方法：随机抽查南宁市3个城区的精神分裂症患者,采用自编调查表、综合生活质量评定问卷（GQOLI-74）、简明精神病评定量表（BPRS）、社会功能缺陷量表（SDSS）、和日常生活能力量表（ADL）进行入户调查。结果：已婚精神分裂症患者精神症状控制与改善优于未婚者,其日常生活能力、社会功能、综合生活质量评分高于未婚者。精神分裂症患者职业状况与GQOLI-74生活质量呈正相关;SDSS、ADL、BPRS与GQOLI-74呈负相关。结论：精神分裂症患者婚姻及职业状况与生活质量显著相关。     

住院慢性精神分裂症患者个体和社会功能的评估及影响因素分析

目的:分析住院慢性稳定期精神分裂症患者的个人和社会功能及其影响因素。方法:对120例住院慢性稳定期精神分裂症患者采用个人和社会功能量表中文版(PSP)、患者健康问卷(PHQ)及阳性和阴性症状量表(PANSS)等进行个人和社会功能及精神病性状的评估。并对结果进行分析。结果:个人和社会功能低下患者2例(1.7%),有不同程度的能力缺陷患者72例(60.0%),社会功能和人际交往无困难或有轻微困难患者46例(38.3%);患者的个人和社会功能与性别(r=0.568,P0.01)及本次病程(r=-0.362,P0.01)存在显著相关性,患者的干扰和攻击行为与其精神症状显著相关(r=0.30,P0.01)。结论:住院慢性稳定期精神分裂症患者大部分存在不同程度的个人和社会能力缺陷;其中,社会中有用的活动及干扰和攻击行为与患者的精神症状、躯体症状群严重程度及抑郁症状群严重程度显著相关。     

影响精神分裂症患者康复因素的调查分析

目的探讨影响精神分裂症患者的康复因素及干预措施。方法对60例恢复期精神分裂症患者采用自制的回归家庭、社会情况调查问卷进行调查评分,并与社会功能缺陷筛选量表(SDSS)评分进行对照。结果问卷评分高者社会功能损害较轻,问卷评分低者社会功能损害明显(P<0.01)。结论良好的自我管理能力,社会、家庭支持系统对促进精神分裂症患者病情缓解、延缓衰退,提高患者的社会适应能力均有一定积极作用。     

精神活动功能问卷的应用

目的 了解老年慢性精神分裂症患者的社会生活能力，并与Ａｌｚｈｅｉｍｅｒ病（ＡＤ）患者比较。方法 用ｐｆｅｆｆｅｒ精神活动功能问卷（ＦＡＱ）对８５例住院老年慢性精神分裂症患者与４３例ＡＤ病人的社会生活能力进行调查。结果老年慢性精神分理解症患者的社会生活能力减退亦相当严重。结论在制定精神分理解症的康复措施与疗效评定时，不仅要注意精神症状的改善，还要注意对患者社会生活能力的观察与评估。     

精神分裂症患者家属自测健康状况

目的:了解精神分裂症患者家属的健康状况。方法:采用自测健康评定量表(SRHMS)对46名精神分裂症患者家属和46名一般人群进行自测健康水平评定。结果:精神分裂症患者家属的生理、心理、社会健康因子分及总分均显著低于一般人群(P均<0.01)。除心理症状及负性情绪和社会支持2个维度外,其他7个维度的评分在两组间差异均有显著性(P均<0.01)。结论:精神分裂症患者家属的自测健康水平低于一般人群。     

The ability of modifying cognitive deficits in the area of social functioning in chronic schizophrenic patients

The paper concerns the effectiveness of rehabilitation of chronically ill schizophrenic patients who participate in social skills training. The assumption was that the participation in a four-month training programme (as authored by R. P. Liberman) will improve emotional problem solving, ability to keep in norms and conflict solving as well as the ability of cause-effect thinking. 100 schizophrenic patients and their families participated in the study. Half of those studied participated in the social skills training programme and the half who did not, were the control group. The subjects were examined twice in the four months. The following tools were used: "Means Ends Problem Solving" by Platt and Spivack, "PANSS" by Kay and Fiszbein, "Social-demographic questionnaire". Before the study period the groups did not vary much in the aspect of interpersonal social skills solving. After the training, the participants benefited significantly in the effectiveness of their problem solving and other criteria improved as well. It was concluded that the study of a group of 100 chronic schizophrenic patients who participated in a four month social skills training programme has a significant effect on social skills problem solving. The improvement of those skills consisted of: interpersonal and emotional problem solving, prediction of the consequences of one's actions, cause-effect thinking and alternative thinking.     

Social problem solving in schizophrenia

The recent literature on social skills training has placed an increasing emphasis on the role of cognitive factors in social failure, as opposed to deficits in motoric skills. It has been hypothesized that schizophrenic patients are markedly deficient in social problem-solving abilities, and several programs have been developed to teach problem-solving skills. Despite high face validity, there is little empirical support for these training programs or the problem-solving model on which they are based. Research on information processing and problem solving in nonpatient populations is discussed, and it is concluded that the model used in these treatment programs is not a good representation of the problem-solving process. In particular, means-ends analysis is not an appropriate strategy for dealing with most interpersonal problems and conflicts. The difficulties experienced by schizophrenic patients in social situations might be due to a number of factors other than deficits in problem-solving skill, including sensitivity to negative affect and disordered communication. It is concluded that further research on problem-solving training programs is clearly warranted but that the validity of the problem-solving model and the utility of the training is uncertain.     

Poor perception of nonverbal social-emotional cues in relatives of schizophrenic patients

The present study compared nonverbal social perception in relatives of schizophrenic patients (n = 21) with that of normal controls (n= 19). We hypothesized that relatives would display deficits in social perception and we sought to determine the skills that are associated with this deficit. Relatives performed significantly worse than controls on the Profile of Nonverbal Sensitivity Test (PONS), despite comparable performance on skills hypothesized to be related to nonverbal social perception: visual perception, nonverbal problem solving, facial recognition, facial affect recognition, naming, social judgment, and vigilance. To further explore the relationships among these skills, we calculated correlations between the PONS score and associated skills separately within both the relative and control groups and assessed whether the values of these correlations differed between groups. Correlations that differed significantly indicated a greater association, within relatives, between slower reaction times on vigilance tasks and poor PONS performance. Further research is needed to clarify the nature of this relationship, to better characterize social perception deficits in relatives, and to determine whether these perceptual deficits are part of the genetic diathesis to schizophrenia.     

Social cognition and social problem solving abilities in individuals with alcohol use disorder

Background: Up to now, little is known about higher order cognitive abilities like social cognition and social problem solving abilities in alcohol-dependent patients. However, impairments in these domains lead to an increased probability for relapse and are thus highly relevant in treatment contexts. Method: This cross-sectional study assessed distinct aspects of social cognition and social problem solving in 31 hospitalized patients with alcohol use disorder (AUD) and 30 matched healthy controls (HC). Three ecologically valid scenario-based tests were used to gauge the ability to infer the mental state of story characters in complicated interpersonal situations, the capacity to select the best problem solving strategy among other less optimal alternatives, and the ability to freely generate appropriate strategies to handle difficult interpersonal conflicts. Standardized tests were used to assess executive function, attention, trait empathy, and memory, and correlations were computed between measures of executive function, attention, trait empathy, and tests of social problem solving. Results: AUD patients generated significantly fewer socially sensitive and practically effective solutions for problematic interpersonal situations than the HC group. Furthermore, patients performed significantly worse when asked to select the best alternative among a list of presented alternatives for scenarios containing sarcastic remarks and had significantly more problems to interpret sarcastic remarks in difficult interpersonal situations.

Conclusions: These specific patterns of impairments should be considered in treatment programs addressing impaired social skills in individuals with AUD.     

What Difference Does It Make? Implicit,Explicit and Complex Social Cognition in Autism Spectrum Disorders

We tested social cognition abilities of adolescents with autism spectrum disorders (ASD) and neurotypically developed peers (NTD). A multi-faceted test-battery including facial emotion categorization (FEC), classical false belief tasks (FBT), and complex social cognition (SC), yielded significantly lower accuracy rates for FEC and complex SC tasks in ASD, but no significant differences in performance concerning FBT. A significant correlation between age and performance in a FEC task and in a complex task was found only in ASD. We propose that dynamic and/or fragmented FEC tasks can elicit deficits in implicit processing of facial emotion more efficiently. The difficulties of ASD in solving complex SC tasks can be ascribed to deficits in the acquisition and application of social schemata.     

Analogical reasoning in schizophrenic delusions.

PURPOSE: Reasoning ability has often been argued to be impaired in people with schizophrenic delusions, although evidence for this is far from convincing. This experiment examined the analogical reasoning abilities of several groups of patients, including non-deluded and deluded schizophrenics, to test the hypothesis that performance by the deluded schizophrenic group would be impaired. SUBJECTS/MATERIALS: Eleven deluded schizophrenics, 10 depressed subjects, seven non-deluded schizophrenics and 16 matched non-psychiatric controls, who were matched on a number of key variables, were asked to solve an analogical reasoning task. RESULTS: Performance by the deluded schizophrenic group was certainly impaired when compared with the depressed and non-psychiatric control groups though less convincingly so when compared with the non-deluded schizophrenic group. The impairment shown by the deluded schizophrenic group seemed to occur at the initial stage of the reasoning task. DISCUSSION: The particular type of impairment shown by the deluded subjects was assessed in relation to other cognitive problems already researched and the implications of these problems on reasoning tasks and theories of delusions was discussed.     

Visual binding abilities in the initial and advanced stages of schizophrenia

OBJECTIVE: The study tests the hypothesis that intramodal visual binding is disturbed in schizophrenia and should be detectable in all illness stages as a stable trait marker. METHOD: Three groups of patients (rehospitalized chronic schizophrenic, first admitted schizophrenic and schizotypal patients believed to be suffering from a pre-schizophrenic prodrome) and a group of normal control subjects were tested on three tasks targeting visual 'binding' abilities (Muller-Lyer's illusion and two figure detection tasks) in addition to control parameters such as reaction time, visual selective attention, Raven's test and two conventional cortical tasks of spatial working memory (SWM) and a global local test. RESULTS: Chronic patients had a decreased performance on the binding tests. Unexpectedly, the prodromal group exhibited an enhanced Gestalt extraction on these tests compared both to schizophrenic patients and to healthy subjects. Furthermore, chronic schizophrenia was associated with a poor performance on cortical tests of SWM, global local and on Raven. This association appears to be mediated by or linked to the chronicity of the illness. CONCLUSION: The study confirms a variety of neurocognitive deficits in schizophrenia which, however, in this sample seem to be linked to chronicity of illness. However, certain aspects of visual processing concerned with Gestalt extraction deserve attention as potential vulnerability- or prodrome- indicators. The initial hypothesis of the study is rejected.     

Arithmetic fact retrieval and working memory in schizophrenia.

Despite its importance in every-day life and vocational rehabilitation, arithmetic ability has rarely been investigated in schizophrenic patients. Those few studies reporting arithmetic deficits in schizophrenia, however, administered complex calculation tasks which drew not only on arithmetic abilities, but also on working memory resources known to be impaired in schizophrenia. In the present study, arithmetic abilities and working memory functions were investigated in schizophrenic patients (n=24) and healthy control subjects (n=24). Arithmetic fact retrieval was assessed in single-digit multiplication and corresponding division problems using a result verification task which minimized working memory demands. Problem size and the disparity of the proposed result were manipulated. The storage component of working memory was tested with a digit span forward task and the executive control component with a digit span backward as well as with verbal fluency tasks. Schizophrenic patients performed worse than controls only in the executive tasks. Digit span forward was preserved. In the arithmetic tasks, groups did not differ from each other, and a similar pattern of task manipulations was obtained. Hence, despite the executive control deficit retrieval of arithmetic facts is preserved in schizophrenia. Moreover, the same underlying cognitive processes as in control subjects are involved.     

Effect of L-tryptophan on memory in patients with schizophrenia

SUMMARY: ABSTRACT It has been well established that patients with schizophrenia have impaired cognitive abilities on neuropsychological tasks related to memory. Previous studies also suggest a central role for serotonin in memory. This double-blind crossover study aimed to explore the effect of l-tryptophan, a serotonin precursor, on a variety of memory tasks in schizophrenic patients. Antipsychotic-treated schizophrenic patients in remission (N = 21) were randomly treated with l-tryptophan or placebo and then evaluated at three consecutive points on clinical measures (including Positive and Negative Syndrome Scale for Schizophrenia, Clinical Global Impression, and Extrapyramidal Symptoms Rating Scale) and by neuropsychological tests (including Digit-Span, Paired Association, Rey-Osterich Complex Figure Test, Digit Symbol, Number Facility Test, and the Rivermead Behavioral Memory Tests. Compared with placebo, l-tryptophan had a beneficial effect on memory functions but not on the patients' psychotic state or on the side effects of medications. These preliminary results suggest the possibility of using serotonin precursor to enhance memory function in schizophrenia.     

Feedback about previous action improves executive functioning in schizophrenia: An analysis of maze solving behaviour

Disturbances of executive functions (EF) in schizophrenia have received special attention during the past years, but there is still an ongoing debate whether impairment in EF tasks can be linked to deficits of EF themselves or if they rather reflect impairment of other cognitive functions such as working memory processes that are additionally required for task solving. In the present study, we analyzed whether impairments in the maintenance of previous processing assumed to be related to working memory contribute to the impairments in EF tasks seen in schizophrenia. Twenty-five schizophrenic patients treated with atypical antipsychotic agents and 25 healthy controls matched according to age, sex, and education were instructed to solve novel two-dimensional maze tasks by steering a pen through a system of paths. Low demands on maintaining previous actions by giving feedback on preceding movements (visualising the trace of the pen) were contrasted with high demands, i.e. without such a trace of past processing. Without feedback of previous action, task solution was less successful and the control of motor action was deficient in schizophrenic patients. With feedback, both domains of behaviour improved to the level of healthy controls at the costs of higher time demands. The behaviour of healthy controls was not influenced by the experimental manipulation. Lower demands on the maintenance of previous action seem to enable schizophrenic patients to perform executive functions successfully. But data suggest that task solving of schizophrenic patients is characterized by alterations in the coordination of executive functions with other cognitive processes.