精神分裂症患者认知功能损害与阴阳性症状的关系

目的：探讨精神分裂症认知功能损害与阴性、阳性症状的关系。方法:至73例入组的患者随机给予利培酮、氯氮平治疗12周,并于治疗前、后盲法评定Wisconsin卡片分类测验（WCST）,Wechsler记忆测验（WMS）,阴状症状评定量表（SANS）与阳性症状评定量表（SAPS）。结果：治疗前精神分裂症患者的阴性症状、阳性症状均与认知功能有显著相关。主要与执行功能相关;注意障碍与记忆相关。治疗后,仅SAPS中怪异行为得分与WCST的持续反应数、持续错误数显著相关。结论：精神分裂症的认知功能损害是原发性的,并不是在阳性、阴性症状基础上产生的。     

长期住院男性精神分裂症患者认知功能5年随访及与阴性症状相关分析

目的了解男性长期住院精神分裂症患者5年随访认知功能变化及阴性症状对其影响。方法选取精神分裂症男性患者160名,采用重复性成套神经心理状态测验(RBANS)及阳性和阴性症状量表(PANSS)对患者基线期及随访5年后进行测评。使用SPSS17.0进行统计学分析。结果语言功能、视觉广度随访5年后比基线期评分降低,阴性症状、一般精神病理随访5年后比基线期升高(P≤0.05);阴性症状、一般精神病理与RBANS量表各因子分呈负相关关系(P≤0.05);阴性症状对语言功能及视觉广度有预测效应(P≤0.05),可分别解释语言功能及视觉广度方差变异的23.7%及19.2%。结论长期住院精神分裂症患者随访5年后认知功能减退,阴性症状、一般精神病理加重,阴性症状是语言功能及视觉广度的预测因子。     

对住院精神分裂症患者认知功能障碍的相关因素分析

目的：探讨住院精神分裂症患者认知功能障碍的相关因素。方法：应用MMSE等量表,调查与认知功能障碍相关的因素。结果：单因素分析发现：女性、年龄较大、文化程度较低、 病程较长、住院时间较长、具阴性精神症状、父母文化程度较低等与认知功能障碍有关;logistic回归分析发现,与母亲文化程度较低、具阴性精神症状及住院时间较长关系更为密切。结论：认知功能障碍是缺少知识、学习的不良后果,但不能排除脑器质性病变引起的可能性。     

住院慢性精神分裂症患者个体和社会功能的评估及影响因素分析

目的:分析住院慢性稳定期精神分裂症患者的个人和社会功能及其影响因素。方法:对120例住院慢性稳定期精神分裂症患者采用个人和社会功能量表中文版(PSP)、患者健康问卷(PHQ)及阳性和阴性症状量表(PANSS)等进行个人和社会功能及精神病性状的评估。并对结果进行分析。结果:个人和社会功能低下患者2例(1.7%),有不同程度的能力缺陷患者72例(60.0%),社会功能和人际交往无困难或有轻微困难患者46例(38.3%);患者的个人和社会功能与性别(r=0.568,P0.01)及本次病程(r=-0.362,P0.01)存在显著相关性,患者的干扰和攻击行为与其精神症状显著相关(r=0.30,P0.01)。结论:住院慢性稳定期精神分裂症患者大部分存在不同程度的个人和社会能力缺陷;其中,社会中有用的活动及干扰和攻击行为与患者的精神症状、躯体症状群严重程度及抑郁症状群严重程度显著相关。     

中国精神分裂症患者的事件相关电位研究(英文)

Event-related potentials (ERPs) are objective electrophysiological indicators that can be used to assess cognitive processes in the human brain. Psychiatric researchers in China have applied this method to study schizophrenia since the early 1980s. ERP measures used in the study of schizophrenia include contingent negative variation (CNV), P300, mismatch negativity (MMN), error-related negativity (ERN) and auditory P50 inhibition. This review summarizes the main findings of ERP research in patients with schizophrenia reported by Chinese investigators.     

阴性与阳性症状为主的精神分裂症患者执行功能的比较

目的:探讨以阴性或阳性症状为主的精神分裂症患者执行功能的特点。方法:采用威斯康星卡片分类测验(WCST)、Stroop色词测验(SCW)、空间广度测验、数字序列测验和伦敦塔测验分别对46例以阴性症状为主(阴性症状组)和46例以阳性症状为主(阳性症状组)的精神分裂症患者、以及46名健康者(对照组)进行执行功能测评。结果:阴性症状组和阳性症状组各项执行功能指标治疗前后差异无统计学意义,但两组的各项指标均明显差于对照组(P均0.01)。阴性症状组治疗前后WCST中的完成分类数、持续性错误数、随机错误数、数字序列测验的正序和倒序得分、SCW中的反应时(RTA、RTB、RTC)、干扰效应、以及空间广度测验和伦敦塔测验成绩均差于阳性症状组(P0.05或P0.01)。结论:精神分裂症患者执行功能缺损明显,尤以阴性症状为主的患者缺损更为明显。     

意念与模仿行为训练对精神分裂症患者的效果

目的 探讨意念与模仿行为训练对精神分裂症患者的效果.方法 选择2017年7月～2020年7月期间招募的80例精神分裂症患者为研究对象,按随机数字表法分为对照组和研究组,各40例.对照组采取药物治疗,研究组在对照组的基础上联合意念与模仿行为训练,比较两组的阳性与阴性症状、生活质量以及认知功能.结果 两组治疗前阳性阴性症状...     

住院精神分裂症患者焦虑症状及相关因素的调查分析

应用焦虑自评量表（ＳＡＳ）测查了１９４例住院精神分裂症患者，２１例（１２％）患者有不同程度的焦虑症状，逐步回归揭示影响患者焦虑症状的主要因素为：本次住院时间、药物副反应、氯硝安定及安坦。     

老年慢性精神分裂症患者的叶酸辅助治疗效果

目的 探讨叶酸对老年慢性精神分裂症患者的辅助治疗作用。方法 对100 例老年慢性精神分裂症患者按随机数字表分为对照组和研究组,给予研究组患者叶酸10 mg/d 口服干预,对治疗前后两组血红蛋白、红细胞计数、血同型半胱氨酸、叶酸水平以及简易智力状态检查量表（MMSE）、威斯康星卡片分类测试（WCST）评估结果进行对比分析。结果 经叶酸干预后,与对照组比较,研究组叶酸水平升高,同型半胱氨酸水平降低,血红蛋白、红细胞计数均升高（P＜ 0.05）,与组内治疗前比较差异有统计学意义（P＜0.05）。研究组治疗后阴性量表评分降低,完成分类数提高,与对照组和治疗前比较,差异均有统计学意义,而MMSE评分差异均无统计学意义。结论 老年慢性精神分裂症患者给予叶酸辅助治疗,可以改善患者的贫血等躯体症状,还可以对患者的阴性症状和认知症状起到一定程度的改善作用。     

精神分裂症患者神经系统软体征与阴阳性症状的相关性研究(附120例分析)

应用直线相关回归分析法对120例精神分裂症患者神经系统软体征与阴阳性症状的相关性进行研究,结果表明软体征与阳性症状一般无相关性,仅与怪异行为呈正相关。与阴性症状及其各因子分均呈明显的正相关,支持Crow阴性症状者具有脑的广泛性结构变化的观点。     

Mismatch negativity deficits are associated with poor functioning in schizophrenia patients

BACKGROUND: Schizophrenia patients exhibit widespread deficits in many domains, ranging from abnormalities in preattentional sensory processing to gross impairments in everyday functioning. Mismatch negativity (MMN) is an event-related potential measure that occurs in the absence of directed attention. While many studies have reported MMN deficits in schizophrenia patients, little is known about the functional significance of MMN deficits in schizophrenia patients. OBJECTIVE: To determine if a schizophrenia-linked deficit in MMN, an "automatic" preattentional measure, is associated with impairments in everyday functional status, level of independence in living situation, and the ability to perform tasks routinely encountered in everyday situations. SETTING AND PARTICIPANTS: Twenty-five patients with a DSM-IV diagnosis of schizophrenia recruited from inpatient and outpatient community facilities affiliated with the University of California, San Diego, and 25 healthy, nonpsychiatric, comparison subjects. MAIN OUTCOME MEASURES: Mismatch negativity, clinical symptoms, performance on a multidimensional laboratory-based functional skills assessment battery, clinician ratings on the Global Assessment of Functioning Scale, and level of independence in community living situation. RESULTS: Schizophrenia patients had significantly reduced MMN (P<.001). Greater levels of MMN impairment were associated with lower Global Assessment of Functioning Scale ratings. Consistent with clinical ratings, patients with greater MMN impairments were more likely to live in highly structured vs independent settings. A regional analysis of MMN revealed that the largest correlations of MMN to everyday functioning were present at frontocentral recording sites (eg, r(s) = -0.65). In contrast, MMN deficits were not associated with symptom severity or performance on laboratory-based tasks measuring skills that are often considered necessary for independent living. CONCLUSIONS: This pattern of results suggests that MMN deficits represent a core neurophysiological dysfunction that is linked to global impairments in everyday functioning in schizophrenia patients. These deficits in automatic preattentive information processing account for up to 42% of the variance in global functional status in schizophrenia patients. Thus, basic preattentional cognitive deficits may be excellent measures for predicting functional outcome. Longitudinal studies are needed to better understand the relationships between deficits in automatic sensory information processing, associated neural substrate dysfunctions, and deficits in everyday functioning across the course of the illness.     

Neurocognitive functioning in patients with first-episode schizophrenia

To assess the course of neuropsychological (NP) impairment in schizophrenia, 71 patients with first episode (FE) schizophrenia and 71 healthy controls were given a comprehensive battery of NP tests at index assessment, after a 2-year and after a 5-year follow-up period. By means of the z-score standardization, summary scores for verbal intelligence (VBI), spatial organisation (SPT), verbal fluency (VBF), Verbal learning (VBL), semantic memory (SEM), visual memory (VIM), delay/retention rate (DEL), short-term memory (STM), visuomotor processing and attention (VSM) and abstraction/flexibility (ABS) were constructed. FE schizophrenia patients showed a worse performance compared to controls in all areas investigated, most pronounced in VSM, SEM and VBL. In the majority of cognitive domains, an improvement was found over the 5-year follow-up period without differences between the two groups. However, in VBF patients slightly deteriorated whilst controls improved and in memory functions patients improved less compared to controls. When controlling for relevant confounders, neither conventional nor atypical neuroleptics showed a deleterious influence on NP performance, except on VBF. Our data suggest that NP impairment is already present at the onset of the illness and remains stable over the early course of schizophrenia.     

The assessment of neuropsychological functioning in schizophrenia

Overwhelming evidence suggests that compromised neuropsychological function is frequently observed in schizophrenia. The neuropsychological profile is typically characterized by prominent specific deficits in memory and learning, working memory, executive functions, attention, and processing speed, which are evident on a background of a generalized cognitive deficit. This paper provides a review of studies of neuropsychological functioning in schizophrenia. The main cognitive ability areas affected in schizophrenia are described, and the degree of impairment in each ability area as found in studies of schizophrenia patients is summarized, based on meta-analytic findings. Recent studies that have compared neuropsychological functioning across psychotic disorders are presented, and finally, neuropsychological assessment batteries specifically developed for schizophrenia are introduced.     

Expression of anti-cardiolipin antibodies and inflammatory associated factors in patients with schizophrenia

Numerous studies have implicated a connection between schizophrenia and autoimmune disorders. However, the precise relationship and underlying mechanism are still obscure. To further identify the association between autoimmune disorders and schizophrenia, the mRNA expressions of various cytokines and Toll-like receptors (TLRs) in monocytes are examined by using RT-PCR. Additionally, ELISA and zymography were performed to determine the anti-cardiolipin antibody (aCL) and MMP9 activity in serum form schizophrenic patients. Notably, significantly increased interleukin (IL)-6 and IL-10 mRNA were observed in schizophrenic patients, whereas significant reductions of TLR-3 and TLR-5 mRNA were detected. Moreover, significantly increased levels of aCL antibody and a higher frequency of positive-MMP9 activity were detected in serum from patients with schizophrenia. Meanwhile, no significant association was found between each of the medications and aCL activity. These findings demonstrated autoimmune-related phenomena in schizophrenic patients and further suggested a connection between schizophrenia and autoimmune disorders.     

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。     

Predictors of the accuracy of self assessment of everyday functioning in people with schizophrenia

Despite multiple lines of evidence suggesting that people with schizophrenia have substantial problems in self-reporting everyday functioning and cognitive performance, self-report methods are still widely used to assess functioning. This study attempted to identify predictors of accuracy in self report, both in terms of accurate self-assessment and over-estimation of current functioning. As part of the larger Validating Assessments of Everyday Real-World Outcomes (VALERO) study, 195 patients with schizophrenia were asked to self report their everyday functioning with the Specific Levels of Functioning (SLOF) scale, which includes subscales assessing social functioning, everyday activities, and vocational functioning. They were also assessed with measures of neuropsychological (NP) performance and functional capacity (FC), and were assessed for psychiatric symptomatology. In addition, a friend, relative or clinician informant was interviewed with the SLOF, and an interviewer with access to all information provided by the patient and informant (exclusive of performance-based data) generated "best estimate" ratings of actual, everyday functioning. Patients significantly (p<.001) overestimated their vocational functioning and everyday activities compared to the interviewer judgments. Lower levels of NP and FC performance and everyday functioning on the part of patients were consistently associated with overestimation of their functioning. Patient self-reports were not correlated with any performance-based measures, while interviewer judgments were significantly correlated with patients' performance on NP and FC measures (p<.005). In regression analyses, adjusting for interviewer ratings of functioning, several predictors of the discrepancy between self and interviewer judgments emerged. Higher levels of depressive symptoms were associated with less overestimation in self-reports (p<.001). Delusions, suspiciousness, grandiosity and poor rapport were all significantly (p<.001) associated with over-estimation of functioning compared to interviewer judgments. Poorer NP and FC performance were also associated with over-estimation of everyday functioning, but these results were not statistically significant in multivariate regression models. Consistent with previous studies in schizophrenia, other neuropsychiatric conditions and non-clinical populations, higher levels of depression were associated with increased accuracy in self-assessment. Similarly, lower scores on performance-based measures and judgments of everyday functioning also predicted over-estimation of functioning. Thus, we identified bi-directional predictors of mis-estimation of everyday functioning, even when poor baseline scores were considered. These data suggest that it may be possible to screen patients for their ability to self-report their functioning, but that performance-based measures of functioning provide a less biased assessment.     

Longitudinal assessment of premorbid cognitive functioning in patients with schizophrenia through examination of standardized scholastic test performance

OBJECTIVE: Studies suggest the presence of premorbid cognitive impairment in patients with schizophrenia, yet the onset and course of these deficits remain unclear. The purpose of this study was to investigate the longitudinal course of premorbid cognitive functioning in individuals with schizophrenia by using prospective data obtained from scholastic test results. METHOD: Scores from grades 4, 8, and 11 on the Iowa Tests of Basic Skills and the Iowa Tests of Educational Development were obtained for 70 subjects who later developed schizophrenia. The mean percentile rank of the subjects' scores in the areas of vocabulary, reading comprehension, language, mathematics, sources of information, and an overall composite category were compared with state norms. RESULTS: The subjects scored below the 50th percentile for each category in all three grades, but only language, reading, sources of information, and composite scores from grade 11 were significantly below state norms. With regard to longitudinal course, there was a significant linear decrease in language scores over time. Scores from grade 11 were positively correlated with WAIS-R IQ, verbal fluency, and Rey Auditory Verbal Learning scores at first illness episode. Scores from grade 11 were not significantly correlated with age at illness onset or ratings of disorganized, psychotic, or negative symptoms. CONCLUSIONS: Scholastic test scores at grades 4 and 8 were nonsignificantly below average in this group of children who later developed schizophrenia. However, test scores dropped significantly between grades 8 and 11. This corresponds to ages 13-16 years, or the onset of puberty. Poor or declining scholastic performance may be a precursor to the cognitive impairment seen during the first episode of illness.