精神分裂症伴迟发性运动障碍认知功能的对照研究

目的 了解慢性精神分裂症TD患者是否存在认知功能损害。方法 符合持续性TD诊断标准且年龄低于65岁的慢性精神分裂症患者纳入TD组,对照组为同期住院慢性精神分裂症患者。其性别与TD组配对,年龄、文化程度、目前抗精神病药物各类分别与TD组匹配。两组患者认知功能测验包括:韦氏成人智力量表(WAIS-RC)、韦氏记忆量表(WMS)及威期康星卡片分类测验(WCST)。结果 WAIS-RC测验TD组和对照组语言智商、作业智商、总智商成绩无显著差异,但数字广度、数字符合测验TD组得分明显低于对照组。WMS测验结果显示TD组顺数数、累积、背数测验得分明显低于对照组,TD组记忆商数较低。WCST测验结果显示:两组持续错误数无差异,TD组总反应数、正确数、随机错误数、分类完成数的成绩均关于对照组。二元变量相关分析显示:AIMS得分与记忆商数、总反应数、正确数、随机错误数、分类完成数相关。多元逐步回归分析显示:文化程度、TD、年龄是影响患者认知功能的主要因素。结论 有无TD的慢性精神分裂症患者的智商无显著差异;TD患者存在记忆损害,特别是工作记忆损害;TD患者额叶执行功能差于无TD者;除文化程度、年龄外,TD对患者的认知功能损害有影响。

Control study of cognitive function in schizophrenic patients with tardive dyskinesia

Objective: To explore whether chronic schizophrenic inpatients with tardive dyskinesia have congitive impairment. Methods: TD group included the inpatients who met the persistent TD criteria and younger than 65 (40 patients, 30 males and 10 females). Control group included inpatients without TD staying in hospital at the some period of the study group. Two groups were matched for gender, age, education at level and of antipsychotics. The cognitive function assessment comprised of: Wechsler Adult Intelligence-Revised in China (WAIS-RC) , Wechsler Memory Scale ( WMS) , Wisconsin Card Sort Test (WCST). Results: There are no difference in Verbal IQ, Performance IQ and total IQ scoves betmeen two groups. But TD group showed less scoves in MQ (t = 2.121, P = 0.037); Digit Span (t = 2. 749, P = 0.007) ; Digit Symbol-Coding (t = 1. 988, P = 0.050) ; some subtests of long-term memory ( Spillikin forward, t = 2. 034, P = 0. 045; Cumulate, t=2.121, P = 0.037), instantaneous memory (Digit recite, t=2.231, P=0.029) and WCST performance (total trials, t= 3.713, P= 0.000; correct, t =2. 544, P = 0.013; random error, t = 3. 171, P =0.002; categories completed, t = 3. 544, P = 0. 001). Bivariate Correlat on analysis show that AIMS scores were related to MQ, number of total trials, correction random error and categories completed. Education, TD and age were the main influencial to the cognitive function. Conclusion: Though there is no significant difference of IQ between chronic schizophrenic inpatients with and without persistent TD, the TD group has poorer memory function (especially working memory) and frontal executive function than control group. Besides education and age, TD is an obvious influencial factor to cognitive function.