工作记忆缺陷在首发精神分裂症早期诊断中的作用

目的探讨在不同认知负荷下首发精神分裂症患者的工作记忆损伤及其与症状学和社会功能的关系,为精神分裂症的早期诊断提供参考。方法纳入2016年9月-2017年7月在广州医科大学附属脑科医院门诊就诊且符合《精神障碍诊断与统计手册(第4版)》(DSM-IV)精神分裂症诊断标准的首发精神分裂症患者32例,同时纳入健康人员35例作为对照组,采用阳性和阴性症状量表(PANSS)及个体和社会功能量表(PSP)对患者组的临床症状进行评估,两组均完成面孔和房屋的延迟匹配样本任务,测量其视觉工作记忆,分析其与临床症状的相关性。结果精神分裂症患者的面孔和房屋工作记忆均受损(F均16,P0.01)。在房屋工作记忆的准确性上,患者组和对照组之间的差异随记忆负荷增大而减小(F均9,P0.01)。患者组工作记忆的表现与病程、症状严重程度、抗精神病药物剂量无相关性(P均0.05)。结论首发精神分裂症患者存在视觉工作记忆缺陷,而面孔工作记忆缺陷不易受认知负荷的影响,可能可作为精神分裂症早期诊断的依据之一。

Study of working memory deficit on the diagnosis of first-episode schizophrenia

Objective To explore the working memory deficit of first-episode schizophrenia patients perceived different cognitive loads, and to analyze its relationship with symptomatology and social function, so as to provide reference for early diagnosis of schizophrenia.Methods 32 outpatients with first-episode schizophrenia in the Affiliated Brain Hospital of Guangzhou Medical University from September 2016 to July 2017 who met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) were recruited, meanwhile, another 35 healthy individuals were also enrolled as control group. Patients were assessed using Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance scale (PSP). The visual working memory of all selected subjects was assessed by completing delayed match-to-sample tasks consisted of pairs of faces and houses. Then the correlation analysis was used to elucidate the relationship between the visual working memory and clinical symptoms of patients.Results Schizophrenic patients had impaired working memory for faces and houses (F>16, P<0.01). The difference in accuracy of house working memory between patients and healthy controls was gradually narrowed with the increase of memory loads (F>9, P<0.01). The performance of working memory in patient group was not correlated with course of disease, severity of symptoms, or dose of antipsychotic drugs (P>0.05).Conclusion First-episode schizophrenia patients have visual working memory deficit, in which face working memory deficits are not affected by cognitive load, so it may be one of the basis for early diagnosis of schizophrenia.