首发精神分裂症患者临床特征、认知功能的性别差异

目的比较住院男性及女性首发精神分裂症患者临床特征、认知功能等指标的差异。方法选择符合美国精神障碍诊断与统计手册第4版（DSM—IV）诊断标准的首发精神分裂症住院病人90例，其中男性48例，女性42例。收集临床资料，并使用阳性和阴性症状量表（PANSS）、汉密尔顿抑郁量表（HAMD）评定临床症状；威斯康星卡片分类测验（WCST）、重复性神经心理测查系统（RBANS）检测认知功能。结果男性患者比女性患者首次出现精神症状年龄要早2．8岁，首次住院男性患者年龄比女性患者早3．0岁，差异有统计学意义（P均〈0．05）；吸烟在男性患者中比例显著高于女性，差异有统计学意义（P〈0．001）；男性患者单身（未婚或离异）比例显著高于女性，差异有统计学意义（P〈0．05）。RBANS、WCST测查两性之间差异不显著，无统计学意义（P均〉0．05）；在精神症状方面，男性患者的夸大症状及情感交流障碍比女性更突出，差异具有统计学意义（P〈0．05），但PANSS总分、各分量表分及HAMD评分在两者之间差异不显著，无统计学意义（P均〉0．05）。结论首发精神分裂症患者男性发病年龄要早于女性；在精神症状方面男性于女性之间存在着一定的差异；认知功能两者之间无差异；男性患者单身比例显著高于女性。

Gender difference in clinical features and cognitive function of first-episode schizophrenics

Objective To investigate the gender difference in clinical features and cognitive function of first--episode schizophrenics. Methods Ninety first--episode schizophrenic inpatients （48 males and 42 females） were enrolled in this study according to the criteria of DSM-IV. Psychiatric symptoms were evaluated with the positive and negative symptom scale （PANSS）, and the Hamilton Depression Scale （HAMD）. Cognitive function was evaluated with WCST （Wisconsin card sort test） and RBANS （repeatable battery for the assessment of neuropsychological status）. Results First--episode psychiatric symptom in male schizophrenics was 2.8 year earlier than female ones in which a significant difference was shown （P 〈 0. 05）. The rate of smoking was markedly higher in males compared to females （P 〈0. 001）. The rate of unmarried was markedly higher in males compared to females （P 〈 0.05）. No significant difference was found in cognitive function between males and females （P 〉 0.05）. The grandeur symptom and emotion disorder were markedly serious in males compared to females （P 〈 0.05）, but no significant difference was shown between males and females in total score of PANSS, subscale score and HAMD （P 〉 0.05）. Conclusions There is gender difference in age of onset, psychiatric symptoms and marry status of first--episode schizophrenia. Gender does not appear to markedly modify the cognitive impairment characteristics of first--episode schizophrenia.