社区精神分裂症患者社会功能与精神症状的相关分析

目的探讨社区精神分裂症患者社会功能和精神症状的相关性。方法对180例社区精神分裂症患者进行社会功能缺陷筛选量表(SDSS)及阳性与阴性症状量表(PAN SS)评定,并对患者的精神症状和社会功能进行相关分析。结果社区精神分裂症患者的社会功能缺陷主要表现在社会性退缩、对环境的兴趣、责任心与计划性方面;SDSS总分、社会性退缩、对环境的兴趣、责任心与计划性及自我照料与PAN SS总分呈显著正相关(r=0.51,P<0.01)。结论精神分裂症患者症状越重,社会功能损害越明显。     

精神分裂症患者情绪认知缺陷及其与精神症状的相关性

目的 探讨精神分裂症患者的情绪认知活动及其与精神症状的相关性.方法 采用中国人面孔情绪测验(CFET)对61例精神分裂症患者进行测试,与57名正常健康者比较,同时作阳性症状量表(SAPS)和阴性症状量表(SANS)评定.结果 分裂症患者CFET6种情绪认知正确数评分均低于对照组,而远隔错误数评分除厌恶情绪外均显著高于对照组.患者CFET评分与诊断分型、住院次数、用药无关,但SAPS和SANS部分症状评分与CFET的正确数评分呈负相关,而与CFET的错误数评分呈正相关.结论 分裂症患者情绪认知损害较为广泛,在病程过程中相对稳定存在,可能与患者广泛脑区网络功能障碍有关.而患者的症状表现与情绪认知缺陷可能存在共同的病理生理基础.     

阴、阳性症状为主的精神分裂症患者神经认知功能的比较研究

目的：探讨阳性症状为主型（阳性型）及阴性症状为主型（阴性型）精神分裂症患者的神经认知功能状况。方法：采用木块图、线方向判断、视觉再生、理解记忆、连线及威斯康星卡片分类（WCST）测验，对25例阴性型精神分裂症患者和20例阳性型精神分裂症患者进行评定。结果：阴性组患者的视觉再生、理解记忆、木块图，连线B时间、思维灵活性以及WCST持续性错误百分数、完成分类数等成绩显著低于阳性组；其中木块图、连线B时间、思维灵活性以及WCST持续性错误百分数指标与SANS总分均有显著相关；视觉再生、理解记忆测验得分及WCST完成分类数与SANS及SAPS总分均有显著相关。结论：不同亚型精神分裂症患者神经认知功能损害的特点不同。顶叶及额叶功能下降与阴性症状关系密切；而颞叶功能下降与阴性、阳性症状均密切相关。     

奥氮平对精神分裂症认知障碍的疗效及糖、脂代谢的影响

目的观察奥氮平对精神分裂症患者认知功能障碍的疗效及其对糖、脂代谢影响。方法将60例接受单一奥氮平治疗的精神分裂症患者,采用修订韦氏记忆量表（WMS--RC）评定记忆功能;威斯康星卡片分类测验（WCST）评定执行功能;PANSS量表评定精神症状;并检测血糖、胆固醇和甘油三脂,分别在治疗前、治疗8周末各测验1次。结果经过8周的奥氮平治疗后,记忆商数显著提高（P〈0．001）,威斯康星卡片分类测验的总测验次数、持续错误数及随机错误数均显著下降（P〈0．05或P〈0．01）;并且奥氮平对记忆功能、执行功能的改善与阳性症状、阴性症状的下降里显著正相关．治疗8周末血糖、胆固醇和甘油三脂水平均显著高于治疗前（P〈0．05或P〈0．01）．结论奥氮平能有效的改善精神分裂症患者的认知功能障碍,但应重视其对糖脂代谢的副作用。     

慢性精神分裂症心理社会干预的研究

目的探讨心理社会干预对慢性精神分裂症患者精神症状及认知功能的影响。方法将100例慢性精神分裂症患者随机分为实验组(药物治疗联合心理社会干预组48例)和对照组(单纯药物治疗组52例)。分别在两组入组时及治疗3个月后进行阳性症状和阴性症状评定量表(PAN SS)和听觉事件相关电位的评定。结果 3个月后,实验组PAN SS评定阴性量表分、反应缺乏因子和抑郁因子评分均下降(分别为t=2.01,2.10,2.04;P均<0.05),事件相关电位靶刺激P 3潜伏期缩短和波幅升高(分别为t=3.04,P<0.01;t=2.04,P<0.05)。结论心理社会干预对改善慢性精神分裂症患者的精神症状及认知功能有重要作用。     

加味桂枝茯苓汤合并利培酮治疗慢性精神分裂症的临床疗效分析

目的探讨加味桂枝茯苓汤合并利培酮治疗慢性精神分裂症的疗效和安全性。方法将符合研究标准132例的患者,随机分为实验组加味桂枝茯苓汤组,中药每日1剂,水煎成200m l,每日1次口服和对照组进行为期12周的治疗。分别在治疗前及治疗后4、8、12周进行阳性与阴性症状量表（PAN SS）和不良反应量表（TESS）评定。结果治疗12周后实验组的显效率明显优于对照组（χ2=7.93,P〈0.01）,PAN SS总分、阴性症状和一般病理分均有显著性差异（P〈0.01）。结论加味桂枝茯苓汤合并利培酮对难治性精神分裂症不失为有效和相对安全的药物。     

疾病稳定期精神分裂症患者眼区情绪识别缺陷及其与焦虑、抑郁情绪的相关性

目的比较疾病稳定期精神分裂症患者与正常对照者眼区基本、复杂情绪识别能力的差异,探讨精神分裂症患者眼区情绪识别能力与其焦虑、抑郁情绪的关系。方法采用基本情绪识别任务（EBEDT）和眼区复杂情绪识别任务（ECEDT）对101例精神分裂症患者和63例正常对照者进行评估,同时对患者作阳性和阴性症状量表（PAN SS）、焦虑自评量表（SA S）和抑郁自评量表（SDS）评定。结果患者组EBEDT总正确数（13.77±3.71）和怒正确数（2.07±1.17）以及ECEDT正确数（17.85±4.37）均低于对照组[分别为（15.87±2.56）、（3.08±0.85）和（20.49±3.56）,均P＜0.01]。控制PAN SS总分的偏相关分析显示,患者SA S评分与EBEDT总正确数（r=-0.306,P＜0.01）、悲（r=-0.245,P＜0.05）、喜（r=-0.250,P＜0.05）、惊（r=-0.260,P＜0.01）的正确数,以及ECEDT总正确数（r=-0.209,P＜0.05）呈负相关;SDS评分与EBEDT总正确数（r=-0.318,P＜0.01）及喜（r=-0.233,P＜0.05）、怒（r=-0.263P〈0．01）和惊（r=-0．223,P〈0．05）的正确数呈负相关。结论稳定期精神分裂症患者存在眼区的基本和复杂情绪识别能力缺陷,其眼区情绪识别能力与患者的焦虑和抑郁情绪状态存在相关。     

精神分裂症患者一级亲属的阴性症状和认知功能研究

目的 :探讨精神分裂症一级亲属的阴性症状和认知功能。方法 :采用威斯康星卡片分类测验、持续注意测验、词语解释、数字广度、词语广度和空间广度测验 ,阴性症状量表等评估认知功能和阴性症状。结果 :词语解释、CPT视觉 /听觉漏报、反应时间和WCST持续错误数、总应答数、随机错误数等在对照组亲属、单发家系亲属、高发家系亲属中呈渐差趋势 ,阴性症状也有相同趋势 ,单发家系亲属评分介于对照亲属与高发家系亲属之间。与对照组相比 ,病例组一级亲属的WCST的正确分类数、完成分类数更少 ,视觉 /听觉反应时间更长 ,视觉漏报更多 ,阴性症状更明显 ,这些差异有非常显著性意义。结论 :精神分裂症患者部分一级亲属有不同程度的认知功能损害和一些阴性症状。具有一定的遗传特质性 ,是发生精神分裂症的高危人群。     

社区精神分裂症患者对家属生存质量的影响

目的探讨社区精神分裂症患者症状对家属生存质量的影响。方法对167例社区精神分裂症患者进行阳性与阴性症状量表(PAN SS)评定,对患者家属用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)进行评定,并对患者的症状与家属的生存质量进行相关分析。结果社区精神分裂症患者的PANSS总分与家属WHOQOL-BREF总分呈显著负相关(r=-0.225,P0.001)。结论社区精神分裂症患者的症状会影响家属的生存质量,改善患者症状,有利于提高家属的生存质量。     

用阳性和阴性症状量表与ERP观察心理社会干预对慢性精神分裂症康复的影响

目的：应用精神分裂症阳性症状和阴性症状量表（PANSS）评分和事件相关电位（ERP）检测,探讨药物治疗联合心理社会干预对慢性精神分裂症病人精神症状及认知功能的影响。方法：将符合入组标准的100例慢性精神分裂症患者随机分为干预组（药物治疗联合心理社会干预,48例）和对照组（单纯药物治疗,52例）。分别在两组人组时及治疗3个月时进行PANSS评分和听觉ERP检测。结果：经3个月治疗,与对照组相比,于预组PANSS评定阴性量表分、反应缺乏因子和抑郁因子评分下降（P〈0．05）,ERPP3波潜伏期缩短和波幅升高（分别为P〈0．01,P〈0．05）。结论：心理社会干预对改善慢性精神分裂症患者的精神症状及认知功能有重要作用。     

精神分裂症患者探究性眼球轨迹运动与认知障碍

目的 探讨精神分裂症患者眼球轨迹运动、认知障碍及相互关系。方法 对39例精神分裂症病人进行了眼球轨迹运动检查及韦氏记忆、划消测验、威斯康星分类测验的检查，并与36例正常人进行了对照，就眼球轨迹运动与认知之间的关系进行了分析。结果 精神分裂症病人存在眼球轨迹运动异常，其认知障碍广泛，包括记忆、注意及执行障碍，眼球轨迹运动与认知的各个方面均有关系，眼球注视点(NEF)与阳性症状有关，但与病程无关。结论 精神分裂症患者认知损害影响其眼球轨迹运动，两者可能为精神分裂症易惠标志。     

氯丙嗪和利培酮对首发精神分裂症患者认知功能的影响

目的 比较氯丙嗪和利培酮对首发精神分裂症患者认知功能的影响。方法 将100例首发精神分裂症住院患者随机分为氯丙嗪组（50例）和利培酮组（50例）,进行开放性对照研究。在治疗前和治疗后第8周末各做1次韦氏成人智力量表（WAIS-R）、韦氏记忆量表（WMS）和威斯康星卡片分类测验（WCST）。结果 治疗第8周末,利培酮组各项认知功能检查结果明显好于氯丙嗪组（P〈0．05）;在控制可能的干扰因素（入组时测查水平、年龄、文化程度、药物副反应的程度）后,大部分检查结果两组之间差异仍正著,利培酮组各项认知功能指标均有好转,而氯丙嗪姐6项中有3项恶化。结论 对首发精神分裂症患者,利培酮治疗对其认知功能有改善作用,而氯丙嗪对认知功能的某些方面有损害。     

伴迟发性运动障碍的慢性精神分裂症患者认知功能研究

目的:了解伴迟发性运动障碍(TD)的慢性精神分裂症患者认知功能的损害情况。方法:以82例伴TD的(TD组)、70例不伴TD的慢性精神分裂症患者(非TD组)为研究对象,两组一般情况相匹配,选用韦氏记忆测验(WMS)、威斯康星卡片分类测验(WCST)及连线测验(TMT)进行认知功能评定。结果:①两组在WMS方面比较无统计学差异。②两组在WCST方面比较,TD组错误应答数、选择错误率、错误思考时间、持续应答数及概念化水平百分数成绩均显著差于非TD组。③两组在TMT方面比较,TD组PartB耗时数显著长于非TD组,而两组PartA耗时数无显著差异。结论:伴TD的慢性精神分裂症病人存在明显的认知功能损害,且可能涉及额叶皮层。     

The dimensional complexity of the EEG during cognitive tasks reflects the impaired information processing in schizophrenic patients.

The aim of the present study was to investigate whether schizophrenic patients show a different change of the dimensional complexity of the EEG, as represented by the Grassberger-Procaccia correlation dimension D(2,) under cognitive challenge compared to normal control subjects. With respect to results reported in the literature, it was expected that the complexity of the signal under cognitive challenge is higher in schizophrenic patients than in normal control subjects reflecting the impaired information processing abilities of the patients. Eighty-seven schizophrenic and 30 matched control subjects performed two different types of the continuous performance task. The results revealed differences between schizophrenic patients and control subjects for the performance as well as the complexity measures. Schizophrenic patients produced more omission errors than normal subjects did. For the EEG complexity measure no differences occurred under the baseline condition. In contrast, during the first minute under task conditions the control subjects showed a decrease of the dimension while no changes were found for the schizophrenic group. These results occurred for both types of the cognitive task but they reached clear significance only in one of them. The results are interpreted as reflecting the ability of normal subjects to adapt their information processing system to the cognitive challenge and to focus their attention on the task while schizophrenic subjects do not show this adaptation to the task.     

首发精神分裂症重复神经心理测查系统分析

目的用重复神经心理测查系统探讨首发精神分裂症的认知功能损害特点。方法对53例首发精神分裂症患者和62例健康对照用重复神经心理测查系统（RBAN S）和Stroop色词测验进行检测。结果在Stroop色词测验中,病人组的成绩均比对照组差,且差异有统计学意义（P〈0.05）。在RBAN S测查中,病人组5个因子的成绩均比对照组差,且差异有统计学意义（P〈0.05）。结论首发精神分裂症患者可能存在比较严重的全面认知功能损害,范围比较广。     

Comparative neurobiological and neuropsychological deficits in adolescent and adult schizophrenic and nonschizophrenic patients

A group of 24 adolescents and young adults were classified according to four measures using Research Diagnostic Criteria on the dimension of the severity of their schizophrenic syndrome. Independent assessments by the Gottschalk-Gleser Social Alienation-Personal Disorganization Scale and the Abrams-Taylor Emotional Blunting Scale corroborated that the definite schizophrenic group (n = 7) was significantly more schizophrenic than the not schizophrenic group (n = 12), but not more so than the probably schizophrenic group (n = 5). The Halstead-Reitan Category Test and Rhythm Test significantly differentiated the definite schizophrenic group from the not schizophrenic group with respect to cognitive impairment. The Gottschalk-Gleser Cognitive Impairment Scale did not indicate a significant difference in cognitive function between these patient groups. The computerized EEG revealed a significantly higher percent of EEG abnormalities among the definite and probably schizophrenic groups than the not schizophrenic group of patients. These findings are analyzed and discussed.     

Executive function in patients with remitted bipolar disorder and schizophrenia and its relationship with functional outcome.

BACKGROUND: Recent studies have reported that differences in cognitive performance between schizophrenic and bipolar patients seem to be smaller than expected. Patients with schizophrenia have consistently shown frontal executive dysfunctions, but studies regarding executive abilities in bipolar patients are scarce and discrepant. As executive function has been associated with psychosocial functioning in schizophrenia, we wanted to investigate if such a relationship is also present in bipolar disorder and the differences between the two groups. METHODS: Executive function was assessed in 49 euthymic (at least 6 months in remission, Hamilton Depression Rating Scale < or = 8 and Young Mania Rating Scale < or = 6) bipolar and in 49 schizophrenic, residual-type (with at least 1 year without acute exacerbation and predominant negative symptomatology) patients, by the Wisconsin Card Sorting Test (WCST), FAS Test (COWAT) and Trail Making Test. Baseline clinical and psychosocial variables were controlled and psychopathology evaluated by means of the Positive and Negative Syndrome Scale (PANSS). RESULTS: The two groups showed a similar pattern of cognitive deficits in tests of executive function, except for the number of categories achieved in the WCST, which was significantly lower in the schizophrenic group (F = 7.26; p = 0.009). Functional outcome was predicted by the negative syndrome (PANSSN) and perseverative errors (WCST) in schizophrenic patients, and general psychopathology (PANSSG) was the best predictor of functional outcome in the bipolar group. CONCLUSION: Executive function was a good predictor of functional outcome in the schizophrenic group, whereas clinical variables were more predictive of the bipolar one. Patterns of cognitive disturbances in tasks of executive function are similar in both groups but quantitatively more marked in schizophrenia.     

认知负载状态下的精神分裂症患者脑电图特异性研究

认知功能损害是精神分裂症的三大原发症状之一,在疾病早期发现和高危人群风险预警等方面具有重要价值。为了研究精神分裂症患者在认知负载状态下的脑电图特异性,本试验收集17例精神分裂症患者和19例健康受试者的脑电信号作为对照,基于小波变换提取各频段信号,计算非线性动力学及脑功能网络属性等特征,并利用机器学习算法将两类人群进行自动分类分析。试验结果表明,两组受试者在认知负载状态下,Fp1和Fp2导联在α、β、θ、γ这4个频带的关联维数和样本熵的差异均具有统计学意义,提示大脑额叶功能损伤是精神分裂症认知功能损害的重要原因。进一步基于机器学习的自动分类分析结果表明,将非线性动力学与脑功能网络属性相结合作为分类器的输入特征,所得分类效果最优,其结果显示准确率为76.77%、敏感度为72.09%、特异性为80.36%。本研究结果表明,脑电信号的非线性动力学和脑功能网络属性等特征,或可作为精神分裂症早期筛查和辅助诊断的潜在生物标记物。     

探讨心理护理对慢性精神分裂症认知功能的影响

摘要目的探讨心理护理对慢性精神分裂症患者认知功能的改善,提高慢性精神分裂症患者的生活质量。方法采用慢性精神病人标准化精神病量表,对52例入组病例随机分组,分别进行观察评分,并进行相关因素的比较。结果心理护理的干预对慢性精神分裂症患者的认知功能产生了其他护理方法不可替代的积极作用。结论在传统护理方法的基础上,介入心理护理的方法更能有效地改善慢性精神分裂症患者的认知功能,明显提高慢性精神分裂症患者的生活质量。     

Delusions in Schizophrenia: A Phenomenological and Psychological Exploration

The psychopathological basis of delusions in schizophrenia is poorly understood. The most enduring of several early theories has suggested a causal link with formal thought disorder, whereas recent approaches have proposed relationships with a variety of cognitive abnormalities. The correlations of delusions with other schizophrenic symptoms and with cognitive functions including semantic memory, executive function, and also probabilistic reasoning bias, were examined in a series of (overlapping) groups of 43–79 schizophrenic patients. Delusions were found to be significantly correlated with formal thought disorder, with evidence for a particular link between bizarreness and fragmentariness of delusions and “loosening of association”. Delusions were not significantly correlated with overall intellectual function or memory, although there was some suggestion of a complex interaction between delusions, formal thought disorder, and semantic memory impairment. No association between delusions, formal thought disorder, and any measure of executive function was found. Although, as a group, schizophrenic patients showed evidence of probabilistic reasoning bias, this was unrelated to presence and severity of delusions.