Relative contribution of antipsychotics,negative symptoms and executive functions to social functioning in stable schizophrenia

The purpose of this study was to examine the relative contributions of antipsychotic medication, negative symptoms and executive functions to impairment in social functioning in a sample of outpatients with stable schizophrenia.     

奥氮平对首发精神分裂症患者疗效及认知功能的影响

目的探讨奥氮平对首发精神分裂症患者的疗效及认知功能的影响。方法对31例首发精神分裂症患者给予口服奥氮平治疗,观察12w。于治疗前后采用阳性症状量表、阴性症状量表、简明精神病量表评定临床疗效,采用韦氏成人智力量表、韦氏记忆量表、韦斯康星卡片分类测验评定患者的认知功能。结果奥氮平治疗12w末,入组患者阴性症状和阳性症状均有明显改善,不良反应轻微;阳性症状量表、阴性症状量表、简明精神病量表评分均较治疗前显著下降（P〈0．01）;韦斯康星卡片分类测验中的错误应答数较治疗前显著下降（P〈0．01）,非持续性错误也有显著下降（P〈0．05）;韦氏记忆量表中的再生、理解、记忆商因子分均显著高于治疗前（P〈0．05）。结论奥氮平治疗精神分裂症疗效显著、安全性高、依从性好,同时又能显著提高患者的部分认知功能。     

疾病稳定期精神分裂症患者自知力水平与执行功能相关性研究

目的 探讨疾病稳定期精神分裂症患者自知力水平与执行功能的相关性,为临床干预提供依据. 方法 对41例有自知力和42例无自知力的疾病稳定期精神分裂症患者、41例健康体检者（对照组）,采用Wisconsin卡片分类测验和自知力与治疗态度问卷进行测评分析. 结果 无自知力组、有自知力组与对照组Wisconsin卡片分类测验总应答数、错误应答数、完成第一个分类所需应答数、持续性错误数、非持续性错误数和概念化水平数评分均有极显著性差异（P＜0.01）;对照组及有自知力组WCST总应答数、错误应答数、完成第一个分类所需应答数、持续性错误数和非持续性错误数评分均显著低于无自知力组（P＜0.05或0.01）,而概念化水平数评分显著高于无自知力组（P＜0.01）;对照组除总应答数、错误应答数显著低于有自知力组（P＜0.05）外,其他项目评分与有自知力组均无显著性差异（P＞0.05）. 结论 精神分裂症患者自知力的缺乏与额叶执行功能损害存在相关.     

抑郁症患者认知功能与血清胶质源性神经营养因子水平相关性研究

目的探讨抑郁症患者血清胶质源性神经营养因子水平与认知功能的关系,为抑郁症的临床治疗提供生物学依据。方法采用酶联免疫吸附法测定抑郁症患者（研究组）治疗前（76例）及治疗8周末（随访到39例）的血清胶质源性神经营养因子水平,并与50名正常对照组进行对比分析;同时采用汉密顿抑郁量表评定患者的抑郁症状,威斯康星卡片分类测验测评患者认知功能。结果研究组治疗前血清胶质源性神经营养因子水平显著低于对照组（P〈0．01）;治疗8周末显著高于治疗前（P〈0．01）,与对照组则无显著性差异（t=0．594,P〉0．05）;同时,威斯康星卡片分类测验中总应答数、持续性错误数及完成分类数均较治疗前有显著改善（P〈0．01）,且血清胶质源性神经营养因子水平与正确应答数呈正相关（R=0．358,P〈0．01）、与持续性错误数呈负相关（R=0．343,P〈0．01）。结论抑郁症患者可能存在血清胶质源性神经营养因子水平低下,抗抑郁药物治疗可显著提高血清胶质源性神经营养因子水平,并改善认知功能。     

5-HT<Subscript>6</Subscript> receptor antagonists improve performance in an attentional set shifting task in rats

Rationale and objective Performance on the Wisconsin Card Sorting Test (WCST), which requires patients to ‘shift attention’ between stimulus dimensions (sorting categories), is impaired in diseases such as schizophrenia. The rat attentional set shifting task is an analogue of the WCST. Given that 5-HT₆ receptor antagonists improve cognitive performance and influence cortical neurochemistry in rats, the present study investigated the effects of 5-HT₆ receptor antagonists upon attentional set shifting in rats. Methods Rats were tested in this paradigm following sub-chronic SB-399885-T or SB-271046-A (both 10 mg kg⁻¹ bid, p.o. for 8 days prior to testing and either 4 or 2 h prior to testing on day 9, respectively). Rats were trained to dig in baited bowls for a food reward and to discriminate based on odour or digging media (Habituation, day 8). In a single session (day 9), rats performed a series of discriminations, including reversals (REV), intra-dimensional (ID) and extra-dimensional (ED) shifts. Results Neither compound altered performance during Habituation. On the test day, both SB-399885-T and SB-271046-A reduced the total trials to reach criterion and the total errors made when data were collapsed across all discriminations (P<0.05–0.01). Further, both compounds significantly reduced the trials to criterion for REV-1 (P<0.05–0.01) and abolished the ID/ED shift. SB-399885-T, but not SB-271046-A, reduced trials required to complete the ED shift (P<0.05) and the number of errors made during completion of the ID (P<0.05) and ED shifts (P<0.01). Conclusion 5-HT₆ receptor antagonists improved performance in the attentional set shifting task and may have therapeutic potential in the treatment of disorders where cognitive deficits are a feature, including schizophrenia.     

WCST应用于ADHD的现状与展望

认知缺陷是注意缺陷多动障碍的核心部分 ,这种缺陷的模型与有前额叶损伤的成人相似 ,推断出注意缺陷多动障碍可能存在前额叶功能损伤。威斯康星卡片分类测验可以从成人其他脑区损伤的病人中辨别出前额叶损伤的病人 ,有证据表明威斯康星卡片分类测验可以从儿童中辨别出注意缺陷多动障碍儿童 ,该文就目前国外把威斯康星卡片分类测验应用于注意缺陷多动障碍的现状作一综述。     

注意缺陷多动障碍儿童威斯康星卡片分类测验的临床价值

目的探讨中国文化背景下汉族注意缺陷多动障碍(ADHD)儿童在威斯康星卡片分类测验(WCST)中的反应特征。 方法对2003-04—2004-03在中山大学附属三院儿童发育行为中心确诊的汉族ADHD儿童57例和63例正常儿童，采用修订版WCST进行了测试分析。 结果WCST的13个指标中ADHD组儿童有7个指标成绩都显著比正常对照组儿童差(P<005，P<001)。ADHD儿童与正常儿童在WCST中持续性错误数(RPE)分别为(2684±1087)与(2283±1035),P<005，总错误数(RE)分别为(5758±1806)与(4933±1855),P<005，持续性反应数(RP)分别为(3039±1388)与(2549±1268),P<005，完成总应答数(RA)分别为(12760±177)与(12286±1104)，P<001，完成分类数(CC)分别为(286±146)与(378±181),P<001，正确应答数百分比(RCP)分别为(5496±1400)与(6050±1338),P<005，概念化水平(RFP)分别为(4080±1761)与(4777±1772),P<005。控制年龄的偏相关分析显示症状、诊断都分别与WCST的多个指标相关，其中完成分类数(CC)与症状、诊断均相关。 结论汉族ADHD儿童的认知功能、认知转移能力、抽象概括能力、概念形成的洞察力不足。推测汉族ADHD儿童可能存在额叶功能缺陷。WCST可以考虑作为ADHD临床诊断的参考测验，其中较稳定的指标是完成分类数。     

Neuropsychological and Behavioral Measures of Attention Assess Different Constructs in Children With Traumatic Brain Injury

Neuropsychological and behavioral measures are used to assess attention, but little convergence has been found between these two assessment methods. However, many prior studies have not considered attention as a multicomponent system, which may contribute to this lack of agreement between neuropsychological and behavioral measures. To address this the current study examined the relationship between the neuropsychological measures that comprise a four-component model of attention and parent-report behavioral ratings of attention problems and hyperactivity. A total of 65 children and adolescents who had sustained a traumatic brain injury (TBI) were included in the study. Principal components analysis identified the four attention components in this sample, which accounted for 80.9% of the variance. However, correlations between the neuropsychological measures of attention and behavioral ratings of attention and hyperactivity were low and non-significant. This minimal correspondence suggests that neuropsychological and behavioral measures assess different aspects of attentional disturbances in children with TBI.     

Associations of serum brain-derived neurotrophic factor with cognitive impairments and negative symptoms in schizophrenia

Brain-derived neurotrophic factor (BDNF) may be involved in the pathophysiology of schizophrenia. The aim of this study was to examine the associations of serum BDNF levels with the cognition and clinical characteristics in patients with schizophrenia. Sixty-three patients with schizophrenia and 52 age- and sex-matched healthy controls were examined with neuropsychological tests. Serum BDNF levels were determined by enzyme-linked immunosorbent assay (ELISA). There were no significant differences in serum BDNF levels between normal controls and patients with schizophrenia. Serum BDNF levels of normal controls showed negative correlations with verbal working memory, but this was not the case with schizophrenic patients. Meanwhile, serum BDNF levels of schizophrenic patients showed positive correlations with the scores of the Scale for the Assessment of Negative Symptoms (SANS) and the Information subtest scores of Wechsler Adult Intelligence Scale Revised (WAIS-R). Serum BDNF levels are related with the impairment of verbal working memory and negative symptoms in patients with schizophrenia.