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1.
精神分裂症认知障碍及其与阴性阳性症状的关系   总被引:6,自引:1,他引:5  
目的 探索精神分裂症认知障碍特点及其与阴性阳性症状之间的关系。方法 比较32例从未用过抗精神病药或停药2周以上的精神分裂症患者以及15例健康受试者的事件相关电位(ERPs)和威斯康星卡片分类测验成绩(WCST),并进行相关分析。结果 与正常受试者比较,多个位点N2和P3波潜伏期延长,P3波幅降低。WCST中分类完成数偏少,持续错误数和总错误数增加。N2潜伏期和波幅与PANSS阳性症状分呈负相关,而WCST总错误数与PANSS总分和阴性症状总分正相关。结论精神分裂症病人存在中枢信息处理障碍,认知障碍与阴性阳性症状之间具有一定的内在联系。  相似文献   

2.
精神分裂症患者利培酮治疗前后认知功能的研究   总被引:11,自引:0,他引:11  
目的 了解利培酮治疗对精神分裂症病人认知功能的影响 ,及认知功能与阳性和阴性症状的关系。方法 对 30例精神分裂症或分裂样精神病患者 ,在利培酮治疗前后进行威斯康星卡片分类测验 (WCST)。结果 治疗后WCST总测验次数、持续错误数、非持续错误数均少于治疗前 ,有显著性差异 ,P <0 .0 1或P <0 .0 5。PANSS总分的改善与WCST总测验次数、持续错误数呈正相关 ;阳性症状量表分的下降与WCST总测验次数、持续错误数、非持续错误数呈正相关 ,与正确反应数呈负相关 ;而阴性症状量表分的下降与WCST的各项指标之间无明显相关关系。结论 经利培酮治疗后 ,精神分裂症病人在症状改善的同时 ,认知功能也有明显提高 ,且认知功能的提高与阳性症状的改善存在着明显相关性 ,而与阴性症状的改善关系不大 ,提示两者可能存在异质性。  相似文献   

3.
目的:探讨慢性精神分裂症患者血清C-反应蛋白(CRP)水平与神经认知功能的相关性。方法:检测50例符合《美国精神障碍诊断与统计手册》第4版精神分裂症诊断标准的女性患者(患者组)和50名健康志愿者(正常对照组)血清CRP水平;采用阳性与阴性症状量表(PANSS)评估患者的临床症状,威斯康星卡片分类测试(WCST)、连线测试(TMT)评估患者的认知功能;对CRP水平与临床症状及认知功能进行相关分析并与正常对照组进行比较。结果:患者组血清CRP水平明显高于正常对照组(t=9.203,P0.001);WCST、TMT测验成绩明显差于正常对照组(t=4.462~6.815,P均0.001)。患者组血清CRP水平与PANSS总分及阴性症状分呈正相关(r=0.422,r=0.372;P0.05);与WCST正确数、完成分类数呈负相关(r=-0.364,r=-0.375;P0.05),与WCST错误总数、持续错误数、随机错误数呈正相关(r=0.341,r=0.346,r=0.381;P均0.05);与TMT-A、TMT-B呈正相关(r=0.411,r=0.483;P均0.05)。结论:慢性期精神分裂症患者存在明显免疫异常,血清CRP水平与认知功能和阴性症状密切相关。  相似文献   

4.
目的:探讨首次发病的青少年精神分裂症患者执行功能及其与精神症状的关系. 方法:采用威斯康星卡片分类测验(WCST)及韦克斯勒记忆量表第3版(WMS-Ⅲ)空间广度测验测试75例首次发病的青少年精神分裂症患者(病例组)和80名健康对照者(对照组)的执行功能;病例组同时应用阳性和阴性症状量表(PANSS)评定病情. 结果:病例组WCST的错误总数、持续反应数和持续错误数显著高于对照组,正确总数显著低于对照组(P均<0.01);WMS-Ⅲ总分和空间广度逆行分显著低于对照组(P均<0.05).病例组PANSS阴性症状分与WMS-Ⅲ空间广度逆行分及总分负相关(r=-0.276,r=-0.230;P均<0.05);阳性症状分与WCST完成分类数负相关(r=-0.258,P<0.05);一般病理学总分与WMS-Ⅲ空间广度逆行分负相关(r=-0.244,P<0.05). 结论:首次发病的青少年精神分裂症患者执行功能显著受损,并与病情有关.  相似文献   

5.
目的:探讨无抽搐电休克维持治疗(M-ECT)对难治性精神分裂症患者的疗效和认知功能的影响。方法:将60例难治性精神分裂症患者随机分为两组,给予研究组药物联合为期26周的MECT,对照组仅使用药物治疗;治疗前、治疗2周、4周、13周和26周分别进行阳性与阴性症状量表(PANSS)、威斯康星卡片分类测验(WCST)、韦氏记忆测验(WMS)评定。结果:治疗后各时间点两组PANSS总分、治疗2周后的阳性症状分、治疗4周后的阴性症状分和一般病理分均较基线时明显下降(P均0.05);研究组PANSS总分在治疗13周、26周明显低于对照组(P均0.05);阳性症状分治疗后各时间点明显低于对照组(P均0.05);阴性症状分和一般病理分在治疗26周明显低于对照组(P均0.05)。治疗13周时,WCST完成分类数、WMS联想得分明显高于对照组(P均0.05);治疗26周时,WCST错误应答数明显低于对照组;WMS再认、联想得分明显高于对照组(P均0.05)。结论:药物联合M-ECT能快速缓解难治性精神分裂症患者的阳性症状,疗效优于单纯药物治疗,并对患者部分记忆和执行功能有改善。  相似文献   

6.
目的探讨氯氮平联合阿立哌唑对长期住院精神分裂症患者的疗效及对认知功能的影响。方法将67例符合《国际疾病分类(第10版)》(ICD-10)诊断标准的长期住院精神分裂症患者随机分为治疗组和对照组,两组实际完成研究各31例。治疗组给予氯氮平联合阿立哌唑治疗,对照组仅给予常规剂量氯氮平治疗,疗程12周;采用阳性与阴性症状量表(PANSS)评定疗效,采用威斯康星卡片(WCST)评定认知功能。结果治疗12周后,治疗组PANSS总评分、阴性症状评分较治疗前低,差异均有统计学意义(P<0.01);WCST评定总正确数、正确率、持续反应数、持续错误数、分类数均优于治疗前,差异有统计学意义(P<0.05)。对照组PANSS总评分、阳性症状评分、阴性症状评分与治疗前比较差异均无统计学意义(P>0.05);WCST评定总正确数、正确率、持续反应数、持续错误数、分类数与治疗前比较差异均无统计学意义(P>0.05)。结论氯氮平联合阿立哌唑治疗对改善长期住院精神分裂症患者的阴性症状及认知功能的效果可能优于单一使用氯氮平治疗。  相似文献   

7.
目的:探讨精神分裂症患者及其一级亲属认知功能和阴性症状的相关性。方法:精神分裂症患者44例及其一级亲属78名完成修订版韦氏成人智力量表的词汇测验(VS)、多维记忆评估量表的数字广度(DS)、汉词广度(WS)和空间广度(SS)测验、威斯康星卡片分类测验(WCST)及持续注意测验(CPT),使用阳性和阴性症状量表(PANSS)的阴性症状分量表对受试者阴性症状进行评估。分析其相关性。结果:患者的VS、WS、SS、大部分WCST和CPT成绩与阴性症状总分相关(P0.05或P0.01);患者亲属的VS、DS、WS、SS、CPT的视觉漏报和视觉反应时间与阴性症状总分相关(P均0.01)。多元逐步回归分析显示,患者的VS、WCST完成分类和正确数、CPT听觉错误和视觉错误进入回归方程,联合预测阴性症状68.8%的变异,患者亲属的VS和CPT视觉漏报联合预测阴性症状63.9%的变异。结论:精神分裂症患者和一级亲属的认知功能与阴性症状有一定的相关性,但不完全重叠。  相似文献   

8.
目的探讨奥氮平对精神分裂症患者认知功能的改善作用。方法使用新韦氏记忆量表(WMSRC)、威斯康星卡片分类测验(WCST)、阳性症状与阴性症状量表(PANSS)、标准化的精神分裂症认知功能成套测验(MCCB)对患者的认知功能进行综合评定。结果治疗8周后,患者的记忆商数较治疗前有显著提高(P0.05);患者总测试次数、随机错误数、持续错误数均显著性下降(P0.05);但分类完成数、正确数无显著性变化(P0.05);患者治疗前后语言记忆及数字序列间存在显著差异(P0.01);治疗前后其迷宫、视觉记忆、空间广度及持续操作测试结果存在显著差异(P0.05),治疗前后患者连线及情绪管理检测结果差异无统计学意义(P0.05);阴性及阳性症状减分值、PANSS总分减分值与患者记忆商数增加值间呈显著正相关关系(P0.05或P0.01);患者PANSS总分减分值和一般病理性症状减分值与随机错误数减分值及阳性/阴性症状减分值与持续错误数减分值间均存在显著正相关关系(P0.05);治疗期间均未出现严重的不良反应。结论奥氮平可以显著改善精神分裂症患者的认知功能障碍,值得临床推广应用。  相似文献   

9.
目的 研究精神分裂症患者认知功能、精神症状和社会功能的相关性.方法 随机选取18例精神分裂症患者,采用听觉事件诱发电位(P300)、神经心理认知测验检测患者与18名正常对照者的认知功能,采用阳性与阴性症状量表(PANSS)和临床总体印象量袁(CGI-S)评定患者的精神症状,采用社会功能量表(PSP)评定患者的社会功能,用锥体外系副反应量表(SAS)、不自主运动量表(AIMS)和静坐不能量表(BARS)评定既往使用抗精神病药物不良反应情况.并研究患者的认知功能、精神症状和社会功能的相关性.结果 精神分裂症患者的潜伏期N1,P2,N2较对照组延长,两组比较差异有统计学意义(P<0.05),但未发现波幅的差异.精神分裂症患者颜色连线2时间较对照组长,范畴流利和Stroop分量表评分均低于对照组,两组比较差异均有统计学意义(P<0.05).因为受教育程度可能会影响患者的认知,故以受教育年限为控制因素,进行偏相关分析,P300的潜伏期和波幅与PANSS总分和各因子分无相关性(P>0.05),与锥体外系和社会功能也无相关性(P>0.05).神经认知心理测试与PANSS、CGI-S无相关性.神经认知心理测试与PANSS、CGI-S无相关性.PSP和颜色连线测验2、WCST总错误数呈负相关,PSP和范畴流利测验、WCST总正确数及分类个数呈正相关(P<0.05).结论 精神分裂症患者存在认知功能障碍,其认知功能与社会功能有明显相关性.  相似文献   

10.
目的:比较阴性和阳性症状为主型精神分裂症患者前额叶和丘脑质子波谱及其与临床症状、执行功能的相关性方法:对61例阴性症状为主型精神分裂症患者(阴性组)和53例阳性症状为主型精神分裂症患者(阳性组),在入组时应用抗精神病药治疗前与治疗后8周末,采用多体素磁共振质子波谱(1H-MRS)检测前额叶和丘脑N-乙酰基天门冬氨酸(NAA)与肌酸复合物(Cr),计算NAA/Cr值;采用阳性和阴性症状量表(PANSS)和威斯康星卡片分类测验(WCST)评定临床症状和执行功能;进行两组1H-MRS、PANSS、WCST的比较与相关分析。结果:治疗前阴性组右侧丘脑NAA/Cr值(1.43±0.33)低于阳性组(1.58±0.35),(t=2.35,P〈0.05);治疗前阴性组分类数(1.68±0.54)低于阳性组(2.06±0.66),(t=3.38,P〈0.01),持续错误数(43.3±11.2)高于阳性组(31.8±9.22),(t=5.95,P〈0.01);治疗前阴性组左侧前额叶NAA/Cr值与阴性症状分、持续错误数呈负相关(r=-0.35,P〈0.05);(r=-0.36,P〈0.01)。治疗前后阴性组左侧前额叶NAA/Cr值变化与阴性症状分变化、持续错误数变化呈负相关(r=-0.30,P〈0.05);(r=-0.29,P〈0.05),与分类数变化呈正相关(r=0.31,P〈0.05)。结论:不同亚型精神分裂症患者可能存在不同的神经生物学基础,阴性症状为主型精神分裂症患者左侧前额叶神经元的损害可能是引起阴性症状、执行功能障碍的生物学基础。  相似文献   

11.
OBJECTIVE: Cognitive function and regional cerebral blood flow (rCBF) were studied in negative symptom profile schizophrenic patients by using WCST and SPECT. METHODS: Twenty-one schizophrenic patients who matched the criteria of Andreason's negative symptom profile received SPECT and WCST, and then were treated with clozapine for 8 consecutive weeks. There were 28 and 12 normal subjects as the control groups of WCST and SPECT, respectively. RESULTS: Compared with controls, significantly poorer performance on total trials of category (TT), persevering errors (PE), and non-persevering errors (NPE) of WCST were found in schizophrenia (p < 0.05). The total score of the scale for assessment negative symptoms (SANS) was significantly related with poor TT (r = 0.45, p < 0.01) and PE performance (r = 0.45, p < 0.01). The poor TT, PE, and NPE tasks of WCST and SANS scores in the negative schizophrenic patients were significantly improved through clozapine treatment (p < 0.05). The schizophrenic patients had a significantly lower rCBF in bilateral frontal and temporal lobes and lower change rate of rCBF in bilateral frontal lobes during WCST compared to normal controls (p < 0.05). CONCLUSIONS: Negative symptom profile schizophrenia has cognitive deficits and lower rCBF in bilateral frontal and temporal lobes, which suggests that negative symptom profile schizophrenic patients have hypofrontality. Clozapine can improve negative symptoms and improve cognitive dysfunction, although it cannot improve reduced rCBF in the frontal lobes.  相似文献   

12.
抑郁症患者和正常人威斯康星卡片分类测验的比较研究   总被引:6,自引:0,他引:6  
目的:探讨抑郁症患者认知功能障碍的特点。方法:对67例符合ICD-10抑郁症诊断标准的抑郁症患者和44例正常人进行威斯康星卡片分类测验(WCST),并对其中21例经过6周抗抑郁药治疗的患者进行治疗产后比较,观察WCST与HAMD评分变化的关系。结果:抑郁症患者WCST的总测验次数,持续错误数和随机错误数同正常人相比较均有显著差异(P<0.01),相关分析发现:WCST的总测验次数,持续错误数,随机错误数与年龄,HAMD总分及迟缓,日夜变化两因子分正相关(P<0.01),正确数和分类数与年龄,HAMD的迟缓因子分成负相关(P<0.05),WCST在两组按性别及文化程度再分组比较后发现,各组间无显著性差异,对21例患者治疗前后比较发现WCST随病情的好转而改善,而治疗前后WCST的总测验次数、持续错误数,随机错误数的减分率与HAMD减分率正相关(P<0.05),结论:抑郁症患者存在认知功能缺损,其认知功能缺损与病情的严重程度及抑郁症的迟滞和日夜变化等症状有关,认知功能的降低可能反映病人额叶功能的缺损。  相似文献   

13.
目的:研究男性精神分裂症患者基于事件的前瞻记忆受损程度以及与临床症状的关系。方法:运用神经心理学方法,测定19例精神分裂症患者和20名健康志愿者为对照组的前瞻记忆成绩、持续注意力及执行功能。结果:精神分裂症患者前瞻记忆中的错误显著高于对照组。该损害与注意力、执行功能障碍呈正相关,与年龄和阴性症状无关。结论:精神分裂症患者能够形成完整的意图,但其监视、识别线索、提取或执行意图的功能受损。该损害可能起因于患者的注意和执行功能障碍,而与其特定症状无关。  相似文献   

14.
精神分裂症认知功能状况及影响因素   总被引:18,自引:9,他引:9  
目的 探讨精神分裂症认知功能的状况及影响因素。方法 对 36例精神分裂症患者在治疗前、治疗后 6周作神经心理测验和阴性及阳性症状量表 (PANSS)、临床总体印象量表 (CGI)、副反应量表 (TESS)、锥体外系副反应量表 (RSESE)的评定 ,并以 36名健康人进行对照。结果 精神分裂症患者与正常对照组比较 ,两组在知识、算术、数字符号、数字广度 (顺、逆 )、木块拼图、瞬时逻辑记忆、视觉再生即刻和延迟、STROOPC W正确数、词汇流畅、TOH总分 ,计划时间、延迟逻辑记忆、WCST所有指标有显著差异 (P <0 0 5 )。阳性症状量表减分率与视觉再生及WCST分类个数成绩的提高呈显著正相关。而阴性症状量表减分率与瞬时逻辑记忆成绩的提高呈显著正相关。安坦的剂量与木块拼图、瞬时逻辑记忆及WCST分类个数 3项成绩的提高呈显著负相关。安定的药量与算术、视觉再生、汉诺塔总分的改善呈显著负相关。结论 精神分裂症患者存在广泛的认知功能的损害 ,其认知功能可能受到阳性症状、阴性症状、安坦及安定药量的影响。  相似文献   

15.
The aim of this study was to evaluate the effects of a new antipsychotic compound on negative symptoms and cognitive deficit in schizophrenia. Psychiatric symptoms and cognition were assessed in 25 patients with schizophrenia, at baseline and after they had taken risperidone for 4 weeks. The Positive and Negative Symptoms Scale (PANSS), the Wisconsin Card Sorting Test (WCST) and two WAIS sub-tests were used to assess the patients. After the study period, both negative and positive symptoms and also measures of cognitive performance improved significantly. The WCST results correlated with negative symptom scores before and after treatment. This suggests that negative symptoms and cognitive deficit have a common underlying substrate which is the target of the risperidone treatment. Our data show that risperidone may have a substantial effect on complex cognitive functions in schizophrenia, and they suggest that certain cognitive deficits are relatively dependent on the negative symptoms of this disorder.  相似文献   

16.
Failure in contextual information processing has been hypothesized as being the single function responsible for several impairments in cognitive tasks and symptoms, through an involvement of the prefrontal cortex, in patients with schizophrenia. A variant of the Continuous Performance Test (CPT) designed specifically to elicit deficits in the processing of contextual information has been administered to 20 schizophrenic patients and 20 healthy controls. The relation to Wisconsin Card Sorting Test (WCST), relatively specific to prefrontal damage and executive dysfunctioning, and clinical status by using scales for the assessment of positive, negative symptoms and outcome has been investigated. The data show that multi-episode schizophrenic patients manifest inability to use contextual information to inhibit habitual response to an ambiguous stimulus and to maintain information across delay, without a general attention deficit. We also found a relationship between contextual reasoning and WCST unique errors, hallucinations, formal thought disorders, and outcome evaluation. Our results further support the hypothesis that the deficit of contextual reasoning could account for cognitive impairments and symptoms of patients with schizophrenia.  相似文献   

17.
We have analyzed eye movement performances in schizophrenics showing primary negative or deficit symptoms (n=16) and non-deficit schizophrenics (n=55), and compared them with those of controls (n=34) in order to study the relationships between negative symptoms and eye movement abnormalities. Patients were subtyped into deficit and non-deficit subgroups using the Schedule for the Deficit Syndrome. Three oculomotor paradigms were used: smooth pursuit, a reflexive saccade paradigm and an antisaccadic task.The smooth pursuit gain was significantly decreased (and the rate of catch-up saccades increased) in schizophrenics as compared with controls, but no difference was observed between patient groups. In the reflexive saccade paradigm, no difference was found between controls and patients, except for latency in deficit patients. In the antisaccade paradigm, the number of errors and the latency of successful antisaccades were significantly increased in schizophrenics as compared with controls. The latency of successful antisaccades in both directions was significantly increased in deficit patients as compared with non-deficit patients. The latency of rightward successful antisaccades was significantly increased as compared with the latency of leftward antisaccades in deficit patients only. However, when patients were classified into negative and non-negative groups using the PANSS, no difference was found in the antisaccade paradigm.Smooth pursuit impairment does not seem to depend on the primary enduring negative symptoms.In deficit schizophrenics, the abnormalities observed in the antisaccadic task are consistent with prefrontal dysfunction, and may suggest parietal lobe dysfunction as well.  相似文献   

18.
BackgroundSchizophrenia involves marked motivational and learning deficits that may reflect abnormalities in reward processing. The purpose of this study was to examine positive and negative feedback sensitivity in schizophrenia using computational modeling derived from the Wisconsin Card Sorting Test (WCST). We also aimed to explore feedback sensitivity in a sample with bipolar disorder.MethodsEighty-three individuals with schizophrenia and 27 with bipolar disorder were included. Demographic, clinical and cognitive outcomes, together with the WCST, were considered in both samples. Computational modeling was performed using the R syntax to calculate 3 parameters based on trial-by-trial execution on the WCST: reward sensitivity (R), punishment sensitivity (P), and choice consistency (D). The associations between outcome variables and the parameters were investigated.ResultsPositive and negative sensitivity showed deficits, but P parameter was clearly diminished in schizophrenia. Cognitive variables, age, and symptoms were associated with R, P, and D parameters in schizophrenia. The sample with bipolar disorder would show cognitive deficits and feedback abnormalities to a lesser extent than individuals with schizophrenia.ConclusionNegative feedback sensitivity demonstrated greater deficit in both samples. Idiosyncratic cognitive requirements in the WCST might introduce confusion when supposing model-free reinforcement learning. Negative symptoms of schizophrenia were related to lower feedback sensitivity and less goal-directed patterns of choice.  相似文献   

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