长程心理动力学心理治疗对首发缓解期精神分裂症患者共情能力及社会功能的影响

目的:观察长程心理动力学心理治疗对首发缓解期精神分裂症患者共情能力及社会功能的影响。方法:15例首发缓解期精神分裂症患者(研究组)在抗精神病药治疗基础上联合长程心理动力学心理治疗,每周1次,持续24周;15例首发缓解期精神分裂症患者(对照组)在抗精神病药治疗基础上辅以每2~4周1次、持续24周的健康教育。采用阳性和阴性症状量表(PANSS)、人际反应指针量表(IRI-C)以及个人和社会功能量表(PSP)对两组患者入组前及随访结束时评估并进行比较。结果:随访24周后,研究组(n=7)IRI-C评分(55.79±12.18)较基线值(38.39±5.89)显著改善(P0.001),PSP评分(65.47±6.24)较基线值(53.18±5.26)有显著改善(P0.001)。随访24周后,对照组(n=7)IRI-C评分(45.16±10.29)较基线值(39.18±4.58)无显著改善(P=0.07),PSP评分(59.39±5.86)较基线值(54.21±5.12)有显著改善(P=0.05)。结论:首发缓解期精神分裂症患者联合长程心理动力学心理治疗有助于提高共情能力及社会功能。     

精神分裂症患者共情能力及相关因素分析

目的 通过比较住院精神分裂症患者治疗前后共情缺陷、社会功能和精神症状的差异,探讨共情能力的相关因素及药物治疗对共情能力的影响。方法 对60例（男30例,女30例）住院精神分裂症患者予新型抗精神病药物治疗3个月,采用人际反应指针量表（IRI—C）、阳性和阴性症状评定量表（PANSS）及个体和社会功能量表（PSP）,分别对患者治疗前后的共情水平、精神症状、社会功能进行评定,比较各项测量指标前后的变化,并通过各测量指标治疗后减分率的相关分析,探讨精神分裂症患者共情能力、临床症状以及社会功能的关系,以及药物治疗对共情能力的影响。结果 精神分裂症患者予新型抗精神病药治疗3个月后,共情能力、精神症状、社会功能均有所改善。治疗前后各项评分减分率进行Pearson相关分析显示,精神分裂症患者的共情能力与阴性症状呈负相关,与社会功能呈正相关。结论 非经典抗精神病药物治疗可改善共情能力、精神症状和社会功能,精神分裂症患者的阴性症状随着共情能力的改善而改善。     

精神分裂症的共情缺陷及其影响因素

目的探讨精神分裂症患者共情缺陷特点及其影响因素。方法采用人际反应指针量表(IRI-C)对208例精神分裂症患者和213名正常对照的共情能力进行评估,同时作艾森克人格问卷(EPQ)、罗森伯格自尊量表(SES)、一般自我效能感量表(GSES)、简易应对方式问卷(SCSQ)、社会支持量表(SSRS)、多伦多述情障碍量表(TAS-20)和阳性与阴性症状量表(PANSS)等评估,分析影响患者共情能力的相关因素。结果与对照组相比,患者组IRI-C总分、观点采择、幻想力和同情关心因子分均明显减低(P0.01)。患者EPQ的神经质(N)分(r=-0.22)和精神质(P)分(r=-0.18)、TAS因子III分(r=-0.30)、SCSQ积极应对分(r=0.21)、SSRS主观支持分(r=0.16)及GSES分(r=0.21)均与IRI-C总分相关(P0.05)。以IRI-C总分为因变量的回归分析结果显示,SCSQ积极应对分、EPQ的N分和P分、TAS的因子III得分进入回归模型,标准化回归系数分别为0.28、0.30、-0.18、-0.18。结论精神分裂症患者存在广泛的共情缺陷,患者个性特质及其应对方式对共情能力具有影响。     

精神分裂症患者社会功能与护理对策

精神分裂症患者社会功能与护理对策朱玲精神分裂症患者出院后急性精神症状基本消失，但常遗留社会功能缺陷。本研究调查其可能的有关因素，并讨论相应的护理对策。对象与方法对象：均系１９９０年１月～１９９４年６月的精神分裂症出院患者，符合ＣＣＭＤ—２诊断标准，病...     

老年精神分裂症患者认知功能与社会功能研究

目的探讨老年精神分裂症患者的认知功能及社会功能损害情况。方法采用一系列标准化神经心理测验工具：韦氏记忆测验（WMS）、威斯康星卡片分类测验（WCST）、简易智力状态检查（MMSE）和日常生活能力量表（ADL），测定45例老年精神分裂症患者（研究组）的认知功能和社会功能，并与42例正常老年人（对照组）作对照。结果研究组在WMS中的经历、定向、1→100、100→1、累加、再认、记图、再生、联想、触摸、理解、背数等项成绩均差于对照组（P均〈0．05或0．01）。WCST研究组总正确数和分类次数均小于对照组，而总错误数、持续错误数和持续反应数均高于对照组（P均〈0．01）。MMSE成绩研究组显著低于对照组（P〈0．05），ADL研究组显著高于对照组（P〈0．05）。结论老年精神分裂症患者存在突出的认知功能和社会功能损害。     

精神分裂症患者认知功能与社会功能的相关性

目的探讨精神分裂症恢复期患者认知功能对社会功能的影响。方法对80例精神分裂症恢复期患者采用瑞文标准测验（CRT）、韦氏成人智力量表（WAIS）、威斯康星卡片测验（WCST）,分别与社会功能缺陷量表（SDSS）进行多重线性回归分析。结果经逐步回归分析显示,WCST中变量（正确反应数、持续错误数、分类数）、WAIS中言语量表分、CRT中瑞文总分进入回归方程,拟合的回归方程均有统计学意义。其中瑞文总分、言语量表分与SDSS呈线性负相关关系,持续错误数与SDSS呈线性正相关关系;比较WCST、CRT、WAIS与SDSS的相关性,回归模型的拟合最好的为WCST。结论精神分裂症患者的认知功能与社会功能有显著相关性,正确的评测及改善认知功能对提高患者的社会功能有重要意义,WCST提供了一个有效预测精神分裂症患者社会功能的重要方法。     

长期住院的男性精神分裂症患者认知功能与社会功能研究

目的:探讨长期住院的男性精神分裂症患者认知功能和社会功能的相关性。方法:采用数字划消测验、言语流畅性测验、连线测验(TMT)-A及-B、动物命名测验、Stroop色-词测验、韦氏智力测验中国版木块图及空间广度测验检测48例病情稳定的男性精神分裂症患者(患者组)及24名健康对照者(对照组)的认知功能;采用住院精神病患者社会功能评定量表(SSPI)评估患者的社会功能;分析患者认知功能和社会功能的关系。结果:患者组各项认知功能测验成绩与对照组差异有统计学意义(P均0.01);相关分析显示数字划消、TMT-A及-B得分与社会功能各因子负相关(r=-0.331~-0.582;P均0.05),其他各项认知功能测验与社会功能各因子正相关(r=0.134~0.633;P均0.05)。结论:长期住院的男性精神分裂症患者存在广泛的认知功能损害,并与社会功能损害程度一致。     

精神分裂症患者社会认知功能治疗的研究进展

本文回顾精神分裂症患者社会认知功能的概念,并对该领域现有研究的研究范畴、药物干预及其与社会功能的关系进行综述.     

长期住院精神分裂症患者的孤独感与共情缺陷

目的探讨长期住院精神分裂症患者的孤独感和共情缺陷特征。方法采用病例对照研究,67例住院时间超过2年的精神分裂症患者为研究组,66例病史大于2年的门诊精神分裂症患者为对照组。所有受试完成一般情况调查表、感情-社会孤独量表(ESLS)和人际反应指针量表(IRI-C)。结果①两组性别、年龄、文化程度差异均无统计学意义(P均0.05);②研究组感情-社会孤独量表总评分高于对照组[(29.78±5.58)分vs.(27.16±3.79)分],差异有统计学意义(t=-3.17,P=0.002),情感孤独与社会孤独因子分也均高于对照组,差异有统计学意义(P均0.05);③研究组IRI-C总评分低于对照组[(31.39±11.02)分vs.(39.69±9.61)分],差异有统计学意义(t=4.61,P0.001),反映共情缺陷的"同情关心"因子评分研究组低于对照组[(9.21±3.46)分vs.(11.18±2.93)分],差异有统计学意义(t=3.55,P=0.001)。结论长期住院精神分裂症患者共情缺陷和孤独感明显,需鼓励患者回归社区以缓解孤独感,降低共情缺陷。     

利培酮对精神分裂症患者社会功能的研究

目的:比较利培酮与氯氮平治疗的精神分裂症患者出院后社会功能状况,方法:随机抽取30例服用利培酮,30例服用氯氮平的精神分裂症患者,用阳性症状和阴性症状量表(PANSS), 明精神病评定量表(BPRS),不良反应症状量表(TESS)评定.出院后半年用社会功能缺陷量表(SDSS)评定,并与某些因素进行相关分析及多元逐步回归分析.结果:半年随访发现,服用利培酮的精神分裂症患者在职业工作,婚姻职能,父母职能和社会退缩等社会功能方面明显好于氯氮平,多元逐步回归分析显示,影响社会功能的因素为经济损失多,男性,不能积极参加组织活动,不能与他人和睦相处,BPRS评分高者社会功能差,服用氯氮平的比利培酮差.结论:利培酮和氯氮平相比,治疗的优势主要不在于副反应方面,而在于能较好地改善社会功能.     

Impairments of social cues recognition and social functioning in Chinese people with schizophrenia

Previous studies have suggested that social cognition deficits, and impaired social functioning, were associated with schizophrenia. However, specificity of the relationships between social cues recognition and social functioning remain largely undefined. The authors speculated that the two were related, and further that recognition of verbal and non-verbal social cues were impaired in people with schizophrenia. A total of 71 people (40 schizophrenia patients and 31 matched normal controls) voluntarily participated in this study. Social cues recognition abilities were measured by the eye gaze discrimination task and the faux pas recognition task. Social functioning was assessed using the Social Functioning Scale. Correlation analysis revealed a significant association between faux pas and, in particular, the social functioning subscales of the Social Functioning Scale (independence and employment) in patients with schizophrenia. Furthermore, the authors also observed that clinical participants performed significantly worse in both the eye gaze discrimination and faux pas recognition tasks than their healthy counterparts. These findings suggested that impaired social cues recognition in people with schizophrenia may be a possible explanation for their impaired social functioning.     

Relationship between clinical outcomes measures and personal and social performance functioning in a prospective,interventional study in schizophrenia

ObjectivesTo explore clinical and demographic characteristics impacting patient functioning by determining extent of overlap in factors driving change in Personal and Social Performance (PSP) and other clinical outcomes.MethodsPost‐hoc analysis from a single‐arm trial of paliperidone extended release in adult patients with nonacute symptomatic schizophrenia. Psychosocial functioning measures: PSP, Clinical Global Impression–Severity (CGI‐S), Positive and Negative Syndrome Scale (PANSS), Short‐Form 36 (SF‐36), treatment satisfaction, sleep quality/daytime drowsiness, and Extrapyramidal Symptoms Rating Scale.ResultsHighest correlations with PSP total score change included PANSS total score change (Spearman''s r = 0.607), PANSS general psychopathology change (r = 0.579), and CGI‐S change (r = 0.569). A PSP score change of −32 predicted 90% probability of deterioration in CGI‐S (score change of ≥1). The power of PSP change to predict PANSS total score change was lower. Linear stepwise regression demonstrated independent relationships for PSP change and: PANSS total change; CGI‐S change; SF‐36 Mental Component change; treatment satisfaction at endpoint; PSP at baseline; previous psychiatric hospitalizations. R ² = 0.55 meant that 45% of PSP variation could not be explained by other clinical outcome measures.ConclusionsPsychosocial functioning improvement is important in schizophrenia. PSP may be valuable for assessing functioning; it encompasses psychosocial and clinical factors not measured by other established assessments.     

Predictors of social cognition in patients with schizophrenia

The goal of this study is to explore neurocognitive, clinical and community functioning variables in order to predict “social reasoning” in a sample of patients with a diagnosis of schizophrenic disorder. Cognitive and community functioning, and social reasoning have been evaluated, together with the Positive and Negative Syndromes Scale (PANSS) and DSM-IV Global Assessment of Functioning (GAF), in a sample of 46 patients who met the DSM-IV criteria for schizophrenia. Our findings show that global functioning as reflected by GAF is the strongest predictor of the social reasoning as evaluated by the Wason’s Selection Task (WST). Other community functioning variables such as the Life Skills Profile (LSP) sub-scores do not provide significant prediction of social reasoning. Similarly, neurocognitive measures, in terms of attention and contextual reasoning, have no predictive effect on social reasoning. Our findings show that social cognition should be considered as an additional cognitive domain more related to functional outcome.     

Advanced parental age at birth is associated with poorer social functioning in adolescent males: shedding light on a core symptom of schizophrenia and autism

Background: Evidence indicates an association between older parents at birth and increased risk for schizophrenia and autism. Patients with schizophrenia and autism and their first-degree relatives have impaired social functioning; hence, impaired social functioning is probably an intermediate phenotype of the illness. This study tested the hypothesis that advanced father''s age at birth would be associated with poorer social functioning in the general population. To test this hypothesis, we examined the association between parental age at birth and the social functioning of their adolescent male offspring in a population-based study. Methods: Subjects were 403 486, 16- to 17-year-old Israeli-born male adolescents assessed by the Israeli Draft Board. The effect of parental age on social functioning was assessed in analyses controlling for cognitive functioning, the other parent''s age, parental socioeconomic status, birth order, and year of draft board assessment. Results: Compared with offspring of parents aged 25–29 years, the prevalence of poor social functioning was increased both in offspring of fathers younger than 20 years (odds ratio [OR] = 1.27, 95% confidence interval [CI] = 1.08–1.49) and in offspring of fathers 45 years old (OR = 1.52, 95% CI = 1.43–1.61). Male adolescent children of mothers aged 40 years and above were 1.15 (95% CI = 1.07–1.24) times more likely to have poor social functioning. Conclusions: These modest associations between parental age and poor social functioning in the general population parallel the associations between parental age and risk for schizophrenia and autism and suggest that the risk pathways between advanced parental age and schizophrenia and autism might, at least partially, include mildly deleterious effects on social functioning.     

Empathy and social functioning in late adulthood

Objectives: Both cognitive and affective empathy are regarded as essential prerequisites for successful social functioning, and recent studies have suggested that cognitive, but not affective, empathy may be adversely affected as a consequence of normal adult aging. This decline in cognitive empathy is of concern, as older adults are particularly susceptible to the negative physical and mental health consequences of loneliness and social isolation. Method: The present study compared younger (N = 80) and older (N = 49) adults on measures of cognitive empathy, affective empathy, and social functioning. Results: Whilst older adults' self-reported and performance-based cognitive empathy was significantly reduced relative to younger adults, there were no age-related differences in affective empathy. Older adults also reported involvement in significantly fewer social activities than younger adults, and cognitive empathy functioned as a partial mediator of this relationship. Conclusion: These findings are consistent with theoretical models that regard cognitive empathy as an essential prerequisite for good interpersonal functioning. However, the cross-sectional nature of the study leaves open the question of causality for future studies.     

Gender differences of neurocognitive functioning in patients with first-episode schizophrenia in China

AimsTo investigate the gender differences in neurocognitive functioning in patients with first-episode schizophrenia (FES) in China.MethodsA total of 449 Chinese patients with FES (210 males, 239 females) were included in this study. Participants’ psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). Neurocognitive functioning was assessed by 10 neuropsychological tests from a battery. Neurocognitive test scores were converted to scale scores and t-scores using normative data from Chinese populations.ResultsMales were younger and less likely to be married, had an earlier age of illness onset and a longer duration of untreated psychosis (DUP), and scored higher on the PANSS negative, general and total scales than females. After controlling for potential confounders, females performed better than males in the verbal learning and memory domain (p=0.016). While most neurocognitive domains were correlated with PANSS negative scores for male patients with FES, for female patients with FES, negative associations were found between scores on the PANSS general subscales and neurocognitive domains. We also performed a case-control comparison with a group of patients with clinically stable schizophrenia (CSS) (n = 60) who were matched by age, sex and education years with patients with FES (n = 58). After controlling for potential confounders, no significant differences were found between patients with FES and patients with CSS in all neurocognitive domains. Female patients still performed better in the verbal learning and memory domain (t = 2.14, p = 0.034). No interaction effects of gender and disease were found.ConclusionsGender was an independent influence factor for the verbal learning and memory domain. Both female patients with first-episode schizophrenia and female patients with clinically stable schizophrenia performed better than male patients.     

Neural disruption to theory of mind predicts daily social functioning in individuals at familial high-risk for schizophrenia

Theory-of-mind (ToM) ability is foundational for successful social relationships, and dependent on a neurocognitive system, which includes temporoparietal junction and medial prefrontal cortex. Schizophrenia is associated with ToM impairments, and initial studies demonstrate similar, though more subtle deficits, in unaffected first-degree relatives, indicating that ToM deficits are a potential biomarker for the disorder. Importantly, the social consequences of ToM deficits could create an additional vulnerability factor for individuals at familial high risk (FHR). However, behavioral studies of ToM are inconsistent and virtually nothing is known about the neural basis of ToM in FHR or the relationship between ToM and social functioning. Here, FHR and non-FHR control participants underwent functional MRI scanning while reasoning about a story character’s thoughts, emotions or physical appearance. Afterwards, participants completed a 28-day online ‘daily-diary’ questionnaire in which they reported daily social interactions and degree of ToM reasoning. FHR participants demonstrated less neural activity in bilateral temporoparietal junction when reasoning about thoughts and emotions. Moreover, across all participants, the degree of neural activity during ToM reasoning predicted several aspects of daily social behavior. Results suggest that vulnerability for schizophrenia is associated with neurocognitive deficits in ToM and the degree of deficit is related to day-to-day social functioning.     

首发与复发抑郁症患者社会功能状况及影响因素分析

目的:探讨首发与复发抑郁症患者社会功能差异及其影响因素。方法:对首发抑郁症患者(首发组,57例)及复发抑郁症患者(复发组,60例)进行简明国际神经精神访谈(MINI)、汉密尔顿抑郁量表17项版本(HAMD-17)、Sheehan残疾评定量表(SDS)、家庭功能量表(FAD)、领悟社会支持评定量表(PSSS)评估,比较两组社会功能,分析影响社会功能的因素。结果:首发组与复发组SDS评分差异无统计学意义;SDS总分与患者年龄呈负相关(r=-0.205,P=0.026),与HAMD-17总分呈正相关(r=0.623,P0.01),与FAD中各维度评分呈正相关(r=0.187~0.400,P0.05或P0.01);多元线性回归分析显示HAMD-17评分及FAD的情感反应维度进入方程。结论:首发与复发抑郁症患者均有社会功能损害;患者抑郁程度以及其家庭成员间情感反应情况是其社会功能损害的重要因素。