强迫症患者与精神分裂症患者的执行功能

目的:比较强迫症和精神分裂症患者执行功能损害的特点。方法:本研究为横断面研究。研究对象为符合中国精神障碍分类与诊断标准第3版诊断标准的强迫症(n=29)和精神分裂症门诊患者(n=30),以及年龄和教育程度匹配的正常对照(n=30)。所有被试接受威斯康星卡片、连线测验、河内塔测验、言语流畅性测验等神经心理学测验评定执行功能。结果:威斯康星卡片测验中,强迫症患者总操作时间短于精神分裂症患者(P0.05),与正常对照接近(P0.05);完成归类数目多于精神分裂症患者(P0.05),与正常对照接近(P0.05);错误应答数目少于精神分裂症患者(P0.05),与正常对照接近(P0.05);完成第一分类所需的应答需要的卡片数目多于精神分裂症患者和正常对照(P0.05)。连线测验中,强迫症患者在连线B的时间和错误数少于精神分裂症患者(均P0.05),与正常对照接近(P0.05)。河内塔测试中,强迫症患者的移动次数和出错次数与精神分裂症患者差异无统计学意义(均P0.05),但多于正常对照(均P0.05)。结论:强迫症总体执行功能水平比精神分裂症水平高,但是概念理解能力差。

Executive function characteristics in patients with obsessive-compulsive disorder and patients with schizophrenia

Objectives: To compare the characteristics of executive function in patients with obsessive-compulsive disorder(OCD) and patients with schizophrenia(SCH).Methods: It was a cross-sectional study.Twenty-nine outpatients with obsessive-compulsive disorder(OCD),30 outpatients with schizophrenia(SCH),and 30 age-and education-matched normal adults were involved in the study.The diagnosis was made according to the Chinese Classification and Diagnostic Criteria for Mental Disorders,Third Edition(CCMD-3).All subjects finished a series of neuropsychological tests,including the Wisconsin card sorting test(WCST),Trail-making test(TMT),Tower of Hanoi(TH),and Word fluency test(WFT).Results: In WCST,the patients with OCD showed shorter operation time than ones with SCH [(6.8±2.7) vs.(9.8±5.6),P<0.05],but nearly as same as the normal controls [(6.2±2.5),P>0.05].The patients with OCD completed more categories than the ones with SCH [(3.0±2.4) vs.(2.9±2.1),P<0.05],but had no difference with normal controls [(3.2±2.0),P>0.05].The patients with OCD had fewer errors than the ones with SCH [(56.56±24.74) vs.(62.88±22.50),P<0.05],but had no difference with normal controls [(46.37±23.17),P>0.05].In the cards number required for completing the first category of WCST,the patients with OCD needed more cards than the other two groups [(50.52±43.66)vs.(48.80±38.68),(27.31±26.93),P<0.05].In TMT,the patients with OCD had fewer operation times and errors than the ones with SCH [(82.78±33.33),(1.04±2.37) vs.(141.16±84.02),(3.28±4.55);P<0.05],but had no difference with normal control [(83.37±46.64),(1.58±2.90),P>0.05].In TH test,the patients with OCD had no difference with those with SCH in the same actions and errors [(44.6±12.8),(0.8±0.9) vs.(49.0±21.2),(2.0±3.9);P>0.05],but more than normal controls [(38.7±13.9),(0.28±0.59),P<0.05].Conclusion: It suggests that the patients with obsessive-compulsive disorder may have better executive function than those with schizophrenia in general,while may have worse concept understanding.