精神分裂症首次发病未用药患者认知功能的改变

目的:探讨精神分裂症首次发病未用药患者认知功能改变的相关性。方法:124例首发未治疗精神分裂症患者为研究组,同期健康体检者60名作为对照组,采用MCCB、Stoop色词测验对两组的认知功能进行评价,采用阳性和阴性症状量表(PANSS)评估症状。结果:研究组患者认知功能各项评分均显著低于对照组,差异有统计学意义(P0.05);相关因素分析结果显示,首发未治疗精神病患者MCCB总分、Stroop色词测验与患者受教育年限呈正相关,与PANSS总分及各因子分呈负相关;数字广度测试与教育年限呈正相关;与阳性症状分、PANSS总分成负相关。回归分析表明精神分裂症患者认知功能与受教育年限及PANSS总分相关。结论:首发未治疗精神分裂症患者认知功能明显低于正常人,且患者的认知受损程度和其精神病症状有关。     

影响男性长期住院精神分裂症患者注意及记忆力的相关因素分析

目的探讨影响男性长期住院精神分裂症患者注意及记忆功能的相关因素。方法采用重复性成套神经心理状态测验(RBANS)中Stroop色词测验(SCW)、持续操作测验(CPT)、数字序列测验、言语记忆及视觉记忆测验对120名男性长期住院(≥5年)精神分裂症患者进行测查,结果与患者一般资料做Pearson相关分析。结果男性长期住院精神分裂症患者的年龄、起病年龄、住院时间、受教育年限、PANSS总分、阴性症状量表分与注意、记忆损害相关,而总病程、既往住院次数、苯海索的使用以及阳性量表分、一般精神病理学分、家族史与注意、记忆损害无明显相关。结论男性慢性精神分裂症患者的注意、记忆损害受多种因素影响,患者症状越重,注意、记忆功能受损越重,尤其阴性症状影响明显,同时,年龄偏大,起病年龄低,文化程度低,住院时间长均影响精神分裂症患者的注意、记忆功能,应该引起临床关注。     

精神分裂症患者住院时间与认知功能

为探讨精神分裂症患者末次持续住院时间长短对认知功能的影响 ,我们对此进行了研究。1　对象和方法患者组为我院男性住院病人 ,符合 CCMD- 2 - R精神分裂症诊断标准 ,均服用经典抗精神病药物 ,共 96例。对照组为从未使用过精神药物 ,无精神症状的正常人 ,共 2 0名。两组在年龄、受教育年限方面差异均无显著性 (P均 >0 .0 5 )。评定工具采用韦氏成人智力量表 (WAIS- R) ,韦氏记忆量表 (WMS) ,语言流利性测验 (L F) ,手指敲击测验 (FTT) ,简明精神病评定量表 (BPRS)。统计方法 :对结果进行χ2 检验。2　结果患者组的认知测查指标同…     

利培酮对精神分裂症首次发病患者认知功能及生活技能的影响

目的:评估利培酮对精神分裂症首次发病患者认知功能、生活技能改善及影响因素。方法:对首发精神分裂症住院患者105例接受利培酮治疗10周;使用精神分裂症认知功能成套测验中文版(MCCB)、Stroop等测验评估认知功能;加州大学圣地亚哥分校基于任务的生活能力测验(UPSA)评估生活技能;阳性和阴性症状量表(PANSS)评估精神症状。结果:与基线比较,治疗后MCCB中连线分数、符号编码、空间广度、数字序列、迷宫、视觉记忆、情绪管理、MCCB总分、Stroop测验得分均提高,差异有统计学意义(P均0.05);UPSA总分、财务技能、交流技能得分均提高,差异有统计学意义(P均0.05);Logistic Regression回归分析显示MCCB疗效与基线PANSS总分存在关联(β=0.03,Wald=4.80,P=0.028,95%CI1.003~1.057)。结论:利培酮对精神分裂症首次发病患者认知功能及生活技能均有改善作用,认知功能改善程度可能与临床症状无关。     

难治性精神分裂症患者及亲属的临床特征和认知功能分析

目的探讨难治性精神分裂症患者及其亲属的临床特征及认知功能。方法:采用PANSS、数字广度和数字符号测验对符合DSM-IV精神分裂症诊断标准和难治性标准的139例患者,66例非难治性患者,以及118例难治性患者亲属,100例正常对照进行认知功能和临床症状的评定。结果:难治性精神分裂症患者在发病年龄、未治期、病程、阴性分量表评分与非难治性患者有显著性差异(P<0.05);在教育年限、数字广度、数字符号方面无显著性差异(P>0.05)。数字广度、数字符号比较,难治性患者、非难治性患者及一级亲属与正常组均有显著性差异(P<0.05)。数字广度和数字符号测验结果与难治性患者的病程、PANSS阴性量表评分和未治期呈显著负相关(P<0.05),与教育年限、起病年龄呈显著正相关(P<0.05)。结论:难治性精神分裂症患者有其特殊的临床特征,和其亲属都具有认知功能的损害。     

急性期双相障碍与重性抑郁障碍患者认知功能损害的对照研究

目的:探讨急性期双相障碍(BD)与重性抑郁障碍(MDD)患者认知功能损害的特点。方法:对57例BD患者(BD组)、48例MDD患者(MDD组)进行重复性成套神经心理状态测验(RBANS)认知功能测验,结果与59名年龄、性别、受教育程度与患者相匹配正常对照者(NC组)比较;分析BD及MDD组中伴精神病性症状的30例患者(伴精神病性症状组)与无精神病性症状患者认知功能差异。结果:BD组中即刻记忆、言语功能、延时记忆及RBANS总分低于NC组,MDD组即刻记忆、言语功能、延时记忆分显著低于NC组(P均0.05),BD组与MDD组间RBANS总分及各因子分差异无统计学意义。伴精神病性症状组的注意量表分明显低于MDD无精神病性症状组(P0.05)。结论:BD及MDD患者均存在多领域的认知功能障碍,伴有精神病性症状的心境障碍患者注意功能受损更严重。     

计算机化认知训练对慢性住院精神分裂症患者认知功能的影响

目的 探讨计算机化认知训练对慢性精神分裂症患者认知功能的影响.方法 采用随机对照研究,将80例慢性精神分裂症患者分为两组,每组40例,均服用抗精神病药维持治疗.研究组患者在使用药物治疗的同时合并计算机化认知训练(干预6周),对照组患者单纯使用药物治疗.采用阳性与阴性症状评定量表(PANSS)和精神分裂症认知功能成套测验(MCCB)在干预前后评定患者的精神症状和认知功能.结果 经过计算机化认知训练后,研究组的MCCB中工作记忆训练分与对照组比较改善明显,差异有统计学意义(P＜0.05),而MCCB中其他项目分及PANSS评分改善不明显,差异无统计学意义(P＞0.05).结论 计算机化认知训练能够改善慢性精神分裂症患者的认知功能,尤其表现在工作记忆上.     

非急性期精神分裂症患者认知功能、精神症状和社会功能的相关性研究

目的 研究精神分裂症患者认知功能、精神症状和社会功能的相关性.方法 随机选取18例精神分裂症患者,采用听觉事件诱发电位（P300）、神经心理认知测验检测患者与18名正常对照者的认知功能,采用阳性与阴性症状量表（PANSS）和临床总体印象量袁（CGI-S）评定患者的精神症状,采用社会功能量表（PSP）评定患者的社会功能,用锥体外系副反应量表（SAS）、不自主运动量表（AIMS）和静坐不能量表（BARS）评定既往使用抗精神病药物不良反应情况.并研究患者的认知功能、精神症状和社会功能的相关性.结果 精神分裂症患者的潜伏期N1,P2,N2较对照组延长,两组比较差异有统计学意义（P＜0.05）,但未发现波幅的差异.精神分裂症患者颜色连线2时间较对照组长,范畴流利和Stroop分量表评分均低于对照组,两组比较差异均有统计学意义（P＜0.05）.因为受教育程度可能会影响患者的认知,故以受教育年限为控制因素,进行偏相关分析,P300的潜伏期和波幅与PANSS总分和各因子分无相关性（P＞0.05）,与锥体外系和社会功能也无相关性（P＞0.05）.神经认知心理测试与PANSS、CGI-S无相关性.神经认知心理测试与PANSS、CGI-S无相关性.PSP和颜色连线测验2、WCST总错误数呈负相关,PSP和范畴流利测验、WCST总正确数及分类个数呈正相关（P＜0.05）.结论 精神分裂症患者存在认知功能障碍,其认知功能与社会功能有明显相关性.     

症状严重程度比认知缺损更与精神分裂症住院患者的社会功能状况密切相关(英文)

背景以往研究表明精神分裂症患者的神经认知缺损和精神病性症状会导致其职业和社会功能降低。目的评估中国精神分裂症男性住院患者的神经认知和精神病性症状与社会心理功能之间的关系。方法选取上海市精神卫生中心的51例住院男性精神分裂症患者,其中40例患者最终完成了个体和社会功能量表(Personal and Social Performance Scale,PSP)中文版、临床疗效总评量表-病情严重程度量表(Clinical Global Impression-Severity,CGI-S)、阳性和阴性症状量表(Positive and Negative Symptom Scale,PANSS)、字母-数字排序以及香港文字记忆学习测试等项目的评定。结果患者PANSS量表的3个临床分量表的分值和社会功能总体评估(PSP总分和CGI-S分值)之间存在明显负相关。患者的神经认知测定结果与症状或社会功能状况均无关。结论对于急性期住院精神分裂症患者而言,临床症状的严重度—而非神经认知缺损程度,与其社会功能水平密切相关。     

50岁以上精神分裂症患者的认知特征

目的：探讨50岁以上精神分裂症患者的认知损害特征及其影响因素。方法：对60例50岁以上精神分裂症患者和40例正常人进行了威斯康星卡片分类测验（WCST）、韦氏成人智力量表（WAIS－R）、韦氏记忆量表（WMS）、语言流利性测验（LF）、手指敲击测验（FTT）、简明精神病评定量表（BPRS）及阴性症状评定量表（SANS）等测查。结果：患者组的所有认知测查结果均较正常人显著减退,且年龄、病程、阴性症状及亚型对患者认知功能有显著影响。结论：年龄较大、病程较长、阴性症状较重及非偏执型的精神分裂症患者认知缺损严重。     

Relationships of age at onset with clinical features and cognitive functions in a sample of schizophrenia patients

BACKGROUND: A number of studies investigated the relationships of age at onset with clinical presentation and cognitive performance of schizophrenic patients. The aim of the present study was to assess demographic and clinical characteristics; psychopathologic, social functioning, and quality-of-life ratings; and neuropsychological measures in a sample of patients with stabilized schizophrenia and to identify which factors independently contributed to a multiple regression model with age at onset as the dependent variable. METHOD: Ninety-six consecutive outpatients with schizophrenia (DSM-IV-TR criteria) were included in the study. Assessment instruments were as follows: a semistructured interview, the Clinical Global Impressions scale, the Comprehensive Psychopathological Rating Scale, and the Positive and Negative Syndrome Scale (PANSS) for psycho-pathology of schizophrenia; the Calgary Depression Scale for Schizophrenia (CDSS) for depression; the Social and Occupational Functioning Assessment Scale and the Sheehan Disability Scale for social functioning; the Quality of Life Scale; and a neuro-psychological battery including the Wisconsin Card Sorting Test (WCST) and the Continuous Performance Test. Two models of multiple regression were tested: the first included clinical features and psychopathologic, social functioning, and quality-of-life scales; the second also considered neuro-psychological variables. Data were collected from October 2001 to November 2002. RESULTS: The first multiple regression showed that age at onset was significantly related to scores on the PANSS subscale for negative symptoms (p =.042) and the CDSS (p =.041); the second regression found a relation of age at onset with PANSS score for negative symptoms (p =.002) and 2 neuropsychological measures, number of preservative errors on the WCST and Continuous Performance Test reaction time (p =.0005 for both). CONCLUSION: Our data indicate that, when results of neuropsychological tests are considered, early age at onset of schizophrenia is associated with severity of negative symptoms and compromised cognitive measures of executive functioning and sustained attention.     

Relationship of psychopathological symptoms and cognitive function to subjective quality of life in patients with chronic schizophrenia

Aims:  The purpose of the present study was to examine the extent of the effects of psychopathological symptoms and cognitive function on quality of life (QOL) in patients with chronic schizophrenia.
Methods:  Data were obtained using the Japanese Schizophrenia Quality of Life Scale (JSQLS), Positive and Negative Syndrome Scale (PANSS), Wisconsin Card-Sorting Test (WCST) Keio version, and Continuous Performance Test (CPT) for 52 schizophrenia patients.
Results:  Stepwise regression analysis showed that PANSS depression/anxiety factors predicted JSQLS psychosocial conditions and motivation/energy, and that WCST Categories Achieved predicted JSQLS symptoms/side-effects.
Conclusions:  Psychopathological symptoms and cognitive function affect subjective QOL in patients with schizophrenia. If the final goal is treatment that improves QOL in a manner that patients themselves are aware of, clinicians probably need to consider a treatment strategy that improves depression/anxiety symptom.     

帕利哌酮对精神分裂症患者临床症状、认知功能及神经营养因子的影响

目的探讨帕利哌酮对精神分裂症患者的临床症状、认知功能及神经营养因子水平的影响,为临床精神分裂症的合理用药提供参考。方法选取在天津市安定医院住院的符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的患者60例为研究组,同期选取60例健康志愿者作为对照组。研究组接受帕利哌酮治疗12周。于治疗前后采用阳性和阴性症状量表(PANSS)评定研究组临床症状;采用Stroop测验(SCWT)、数字符号编码测验(DSCT)、持续操作测验(CPT)和连线测验A(TMTA)评定对照组和研究组认知功能;采用酶联免疫吸附技术检测两组血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)和神经营养因子3(NT-3)水平。结果研究组治疗前后PANSS总评分比较差异有统计学意义[(78.12±11.84)分vs.(38.45±7.24)分,Z=24.14,P0.01];治疗后,研究组认知功能指标(SCWT、CPT、DCST及TMTA时间)、BDNF、NGF及NT-3水平均较治疗前高,但仍低于对照组,差异均有统计学意义(P均0.01)。结论帕利哌酮有助于改善精神分裂症患者的临床症状和认知功能,治疗机制可能与上调血清神经营养因子水平有关。     

阿立哌唑与氯丙嗪维持治疗对女性精神分裂症认知功能的影响

目的探讨阿立哌唑与氯丙嗪维持治疗对女性精神分裂症认知功能的影响。方法入组82例维持期女性精神分裂症患者,其中阿立哌唑组39例,氯丙嗪组43例。观察疗程为52周,于入组时、入组后3月、6月、9月和12月采用阳性与阴性症状量表（Positive And Negative Symptoms Scale,PANSS）评定患者的临床疗效,入组时、入组后6月、12月以威斯康星卡片分类测验（Wisconsion Card Sorting Test,WCST）和连续作业测验（Continuous Performance Test,CPT）评定患者的认知功能。结果PANSS总评分（入组时、入组后3,6、9、12月）两组之间无统计学差异。阿立哌唑组各项认知功能指标均较氯丙嗪组有不同程度的改善。结论阿立哌唑是一种安全有效的新型抗精神病药物,尤其适用于女性精神分裂症患者的维持期治疗,能在一定程度上改善患者的认知功能。     

Intercorrelations between the Personal and Social Performance Scale, cognitive function, and activities of daily living

The aim of this study was to evaluate the intercorrelation between the Personal and Social Performance (PSP) score, cognitive function, and activities of daily living (ADLs). Twenty patients with chronic schizophrenia were recruited; the PSP and ADL scales and psychological assessments including the Wisconsin Card Sorting Test, the Wechsler Memory Scale-Revised (WMS-R), and the Continuous Performance Test (CPT) were administered. Positive correlations between the total PSP scale score and performance in the WMS-R, CPT, and ADL scores were identified. The PSP score was found to be of good reliability for cognitive function and ADL evaluation.     

Is a patient‐administered depression rating scale valid for detecting cognitive deficits in patients with major depressive disorder?

Aims: Although cognitive deficits are a common and potentially debilitating feature of major depressive disorder (MDD), such subjective declines in cognitive function are seldom validated by objective methods as a clinical routine. The aim of this study was to validate the Taiwanese Depression Questionnaire (TDQ) for detecting cognitive deficits in a sample of drug‐free patients with MDD. Methods: The subjects consisted of 40 well‐characterized medication‐free patients with MDD and 40 healthy controls. Clinical and neuropsychological assessments, including the Wisconsin Card Sorting Test, the Wechsler Memory Scale–Revised, the Continuous Performance Test, and the Finger‐Tapping Test, were administered at the time of recruitment. Results: Factor analyses of the TDQ yielded three factors. Memory, attention and psychomotor performance were significantly poorer in patients with MDD. The performances of verbal and delayed memory of the Wechsler Memory Scale–Revised were correlated with the cognitive domains of the TDQ. Generalization of our results must be undertaken with caution considering the relatively small sample size, which could lead to increased β‐error. Conclusion: Cognitive subdomains might be considered important for including in patient‐administered questionnaires used to measure symptoms of MDD when developing a new scale.     

Cognitive performance and basic symptoms in first-degree relatives of schizophrenic patients

The aim of the present study was to examine cognitive performance and basic symptoms (BS) in the relatives of schizophrenic patients. The experimental sample comprised 24 first-degree relatives of patients. Each relative was matched to one control. Cognitive tests were: Continuous Performance Test (CPT), N-Back Working Memory Test (N-BACK), Negative Priming Test (NPT), and Span of Apprehension Test (SPAN). The Basic Symptoms Questionnaire (FBF) was used to measure subjective disturbances. The relatives showed only slightly worse cognitive performance than the controls, especially in the tasks with greater cognitive processing load. The relatives also revealed more BS than the controls in the domain of thought, attention, memory, language, and visual representation. Only CPT performance was hardly associated with BS. The negative correlation between FBF and CPT was strongly evident in the relatives with poorer processing capacity. This finding suggests that the BS are associated with sustained attention performance. Future research is needed to clarify whether BS are related to other cognitive domains.     

Depressive and negative symptoms in schizophrenia: different effects on clinical features

Objective

The primary aim of this study was to investigate whether depressive symptoms were significantly associated with functional outcome measures in a clinically stable group of outpatients with schizophrenia. We also analyzed whether depressive and negative symptoms presented different patterns of predictors.

Method

Seventy-eight consecutive outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for schizophrenia in the stable period were enrolled in this cross-sectional study. Assessment were performed using the Calgary Depression Scale for Schizophrenia, Positive and Negative Syndromes Scale (PANSS), Clinical Global Impression Scale-severity, Social and Occupational Functioning Assessment Scale, Sheehan Disability Scale, and Quality of Life Scale. A neuropsychologic battery including the vocabulary and block design subtests of the Wechsler Adult Intelligence Scale-Revised, Wechsler Memory Scale, Wisconsin Card Sorting Test, and Continuous Performance Test was also administered to the patients. Two multiple regressions were performed testing demographic and clinical factors, rating scales, and cognitive measures as independent variables and Calgary Depression Scale for Schizophrenia and PANSS-negative subscale scores as dependent variables.

Results

Four variables were predictors of depressive symptoms in our sample of schizophrenic patients: 2 outcome measures (Sheehan Disability Scale and Quality of Life Scale), gender, and Continuous Performance Test reaction time. Predictors of negative symptoms were the measures of severity of psychopathology (Clinical Global Impression Scale-severity and PANSS-general psychopathology subscale) and the cognitive tests Wechsler Adult Intelligence Scale-Revised block design and Wechsler Memory Scale.

Conclusion

We found that depressive symptoms in schizophrenia are mainly a function of the level of social adjustment and quality of life, whereas negative symptoms constitute an indicator of severity of schizophrenia. The 2 symptom dimensions showed also distinct cognitive correlates.     

平衡仪治疗前后注意缺陷多动障碍患儿认知功能改善的初步观察

目的　探讨平衡仪治疗 2 0次对注意缺陷多动障碍 (ADHD)患儿认知功能的影响。方法　采用Neurocom公司生产的BalanceMaster平衡仪 ,对 2 0例符合美国精神障碍诊断与统计手册第4版诊断标准、年龄在 10～ 15岁的ADHD患儿进行治疗 ,于治疗前后测试韦氏记忆量表、中国韦氏儿童智力量表 (C WISC)、数字划消、持续操作性测试 (CPT)、动态学习能力测试 (DLM)等项。结果　治疗后 ,患儿韦氏记忆量表的短时记忆 [(6 2± 7)分 ]和记忆商分值 [(10 4± 10 )分 ]以及C WISC中注意 /不分心因子分 [(10 9± 14 )分 ]均高于治疗前 [分别为 (5 7± 8)分、(98± 10 )分和 (10 0± 15 )分 ],差异具有非常显著性 (P <0 0 1) ;在数字划消测试中 ,第一段的净分 (36分 )高于治疗前 (32分 ) ,失误率下降(治疗前后分别为 12 %和 8% ;P <0 0 1) ;CPT测试中的错误率有所下降 ,但差异未达显著性 (P =0 0 8) ,平均反应时及正确率无明显变化 ;在DLM测试中 ,总错误数 (41个 )低于治疗前 (15 7个 ;P <0 0 0 1) ,操作分类 (2级 )高于治疗前 (3级 ;P <0 0 0 1)。结论　平衡仪治疗对改善儿童认知功能有一定疗效 ,特别是在提高注意力、记忆力及冲动控制等方面的疗效较好。     

Cognitive predictors of skill acquisition on social problem solving in patients with schizophrenia

The aim of the study was to evaluate the relationship between social problem solving ability, clinical features and cognitive functions, and determine the predictors of benefit from social problem solving training in 63 patients with schizophrenia. We administered Brief Psychiatric Rating Scale (BPRS), Wisconsin Card Sorting Test (WCST), Digit Span Test, Continuous Performance Test (CPT) and the Assessment of Interpersonal Problem Solving Skills (AIPSS). Only BPRS-positive symptoms subscale was negatively related to AIPSS on linear regression analysis. After the completion of the pretest, the patients were randomized to either problem solving training (n = 32) or control groups (n = 31). Patients in training group received 6 weeks problem solving training in-group modality, and those in control group were treated as usual. We readministered AIPSS at the end of 6 weeks. There were significant changes from pretest to posttest on AIPSS-total, AIPSS-receiving skills, and AIPSS-processing skills score in training group but not in control group. The number of correct answers in WCST and CPT hit rate were the predictors of post-training AIPSS scores in training group. Our findings suggest that skill acquisition on social problem solving is related with cognitive flexibility and sustained attention.