缺陷型与非缺陷型精神分裂症患者的精神症状及认知功能损害的研究

目的分析缺陷型与非缺陷型精神分裂症患者的精神症状及认知功能损害的临床特征。方法选择2013年1月~2015年12月期间于北京市大兴区心康医院就诊的77例稳定期精神分裂症患者,根据中文版缺陷型精神分裂症诊断量表分为缺陷型(24例)和非缺陷型(53例),同时选择社区及广告募集的志愿者50例为对照组。分析三组研究对象的精神症状、认知功能损害的情况。结果缺陷组与非缺陷组患者在总病程、起病年龄、发作次数、吸烟量、一般精神病理评分、简明精神病量表(BPRS)总分、阳性和阴性症状量表(PANSS)总分、阳性症状量表(SAPS)评分以及抗精神病药用量比较,差异均无统计学意义(P>0.05);而缺陷型组的阴性症状量表(SANS)评分明显高于非缺陷型组(P<0.05)。缺陷型组、非缺陷型组的重复性成套神经心理状态测验(RBANS)测验在注意、语言、视觉广度、即刻记忆、延迟记忆的5个认知领域评分以及总分均明显低于正常对照组(均P<0.05),且缺陷型组的RBANS测验在注意、语言、视觉广度、即刻记忆、延迟记忆的5个认知领域评分以及总分均明显低于非缺陷型组(均P<0.05)。缺陷型组、非缺陷型组的Stroop色词测验、听觉惊跳反射指标知觉空间融合前脉冲抑制(PSC-PPI)、知觉空间分离前脉冲抑制(PSS-PPI)和感知空间分离-知觉空间融合(PSS-PSC)评分均明显低于正常对照组(均P<0.05),且缺陷型组的Stroop色词测验、听觉惊跳反射指标PSCPPI、SS-PPI、PSS-PSC评分均明显低于非缺陷型组(均P<0.05)。结论缺陷型精神分裂症患者的听觉惊跳反射以及认知功能方面明显较非缺陷型严重,而缺陷型与非缺陷型精神分裂症患者的精神症状、阳阴性症状无明显差异,提示缺陷型精神分裂症患者的认知功能损害的更严重。

Study on mental symptoms and cognitive impairment in patients with deficient and non-defective schizophrenia

Objective To analyze the clinical features of psychiatric symptoms and cognitive impairment in patients with deficient and non-defective schizophrenia.Methods Seventy-seven patients with stable schizophrenia who were admitted to Xinkang District Hospital in Daxing District,Beijing from January 2013 to December 2015 were selected according to the Chinese version of the Diagnostic Scale for Defective Schizophrenia(24 cases)and non-Defective(50 cases),50 volunteers who selected community and advertisements were selected as the control group.The psychotic symptoms and cognitive impairment of the three groups of subjects were analyzed.Results There were no statistically significant differences between the defect group and the non-defective group in terms of total disease duration,onset age,number of episodes,smoking,general psychopathological score,total BPRS score,PANSS total score,SAPS score,and antipsychotic dose(P>0.05);the SAN score of the defect group was significantly higher than that of the non-defective group(P<0.05).The RBANS test of the defect group and the non-defective group was significantly lower than the normal control group(P<0.05)in the five cognitive areas of attention,language,visual breadth,immediate memory,and delayed memory(all P<0.05).The RBANS test of the type group was significantly lower than the non-defective group in the five cognitive areas of attention,language,visual breadth,immediate memory,and delayed memory(all P<0.05).The Stroop color test and the auditory startle reflex index PSC-PPI,SS-PPI and PSS-PSC scores of the defect group and the non-defective group were significantly lower than those of the normal control group(all P<0.05),and the scores of Stroop color test and auditory startle reflex PSC-PPI,SSPPI and PSS-PSC scores of the defect group were significantly lower than those of non-defective group(all P<0.05).Conclusion The auditory startle reflex and cognitive function of patients with deficient schizophrenia are significantly worse than those of non-defective,while the mental and positive symptoms of deficient and non-defective schizophrenia are not significantly different,suggesting that the cognitive function of patients with deficient schizophrenia is more severely impaired.