精神分裂症首次发病患者及其健康同胞认知功能的比较研究

目的 比较精神分裂症首次发病患者与健康同胞及正常对照认知功能的差异,探讨精神分裂症在认知功能领域的内表型.方法 采用目前常用的范畴流畅测验(CFT)、数字符号编码测验(DSCT)、连线测验(TMT)、韦克斯勒记忆量表第3版(WMS-Ⅲ)空间广度测验(WMS-ⅢSST)、霍普金斯词汇学习测验-修订版(HVLT-R)、简易视觉空间记忆测验-修订版(BVMT-R)、定步调听觉连续加法测验(PASAT)和威斯康星卡片分类测验-64(WCST-64)对92例精神分裂症首次发病患者(患者组)、56例健康同胞(同胞组)和62名健康对照者(对照组)的认知功能进行检测.结果 (1)患者组所有神经心理测验成绩均差于对照组,差异有统计学意义(P＜0.01).(2)同胞组的CFT、DSCT、TMT、HVLT-R即刻记忆和延迟记忆、BVMT-R即刻记忆、PASAT、WCST-64持续错误数、持续反应数和完成分类数的测验成绩差于对照组,差异有统计学意义(P＜0.05).(3)患者组与同胞组的CFT、WCST-64中的持续错误数、持续反应数和完成分类数测验成绩分别为(18.40±12.12)分比( 18.86±5.19)分、(16.48±8.19)分比(14.80±5.86)分、(18.76±10.91)分比(16.86 ±7.73)分、(1.33±2.81)分比(1.63±1.36)分,2组比较差异无统计学意义(P＞0.05),其他神经心理测验成绩比较,患者组差于同胞组,差异有统计学意义(P＜0.05).结论 精神分裂症首次发病患者存在处理速度、工作记忆、言语记忆、空间记忆、注意警觉和执行功能广泛性的认知功能损害,精神分裂症健康同胞存在处理速度、言语记忆、视觉记忆、注意警觉、执行功能的认知缺陷；语义流畅性功能和执行功能可能是精神分裂症的潜在内表型.

Cognitive functioning of first-episode schizophrenia patients and their healthy siblings

Objective To explore difference of neuropsychological tests among first-episode schizophrenia patients,their healthy siblings and healthy controls,and to explore the possible endophenotype of schizophrenia in cognitive function.Methods In all,92 first-episode schizophrenia patients,56 their healthy siblings and 62 healthy controls were assessed with the Category Fluency Test ( CFT),Digit Symbol Coding Test ( DSCT),Trail Making Test (TMT),Wechsler Memory Scale-Ⅲ Spatial Span Test ( WMS-ⅢSST ),Hopkins Verbal Learning Test-Revised (HVLT-R),Brief Visuospatial Memory Test-Revised (BVMT-R),Paced Auditory Seria Addition Test (PASAT),Wisconsin Card Sorting Test-64 (WCST-64).Results The patients showed poorer performance on all measures of neuropsychological tests than healthy controls (P ＜0.01 ).There were significantly lower performances in siblings than controls in CFT,DSCT,TMT,HVLT-R trials 1-3,HVLT-R delay,BVMT-R trials 1-3,PASAT,and perseverative errors,perseverative responses and categories completed of WCST-64 ( P ＜ 0.05 ). There were no significance between patients and siblings in CFT and perseverative errors,perseverative responses and categories completed of WSCT-64 ( 18.40 ± 12.12 ) vs.( 18.86 ± 5.19 ),( 16.48 ± 8.19 ) vs.( 14.80 ± 5.86 ),( 18.76 ± 10.91 ) vs.( 16.86 ± 7.73 ),( 1.33 ± 2.81 ) vs.( 1.63 ± 1.36 ) respectively ] ( P ＞ 0.05 ),but patients performed worse than siblings in other any measures ( P ＜ 0.05 ).Conclusions It indicates that the first-episode schizophrenia patients have multiple cognitive deficits in speed of processing,working memory,verbal learning and memory,visual learning and memory,attention/vigilance,and executive function,and their healthy siblings show cognitive function deficits in speed of processing,attention/vigilance,verbal learning and memory,visual learning and memory and executive function.Semantic fluency function and executive function may be the potential endophenotype of schizophrenia.