精神分裂症患者共情能力及其与执行功能的关系

目的 探讨精神分裂症患者共情能力及其与执行功能的关系.方法 采用人际指针量表(IRI-C)对74例精神分裂症患者进行测试,与69名正常对照者比较,同时作威斯康星卡片分类测验(WCST)、Stroop色词干扰测验和空间n-back测验评估.结果 与对照组相比,患者组IRI-C总分[(46.8±10.0)分,(51.5±9.7)分,(P<0.01)]及观点采择[(9.5±4.2)分,(12.2±3.9)分,(P<0.01]、想象力[(12.5±4.2)分,(15.5±3.8)分,(P<0.01]、共情性关心[(15.9±4.2)分,(17.3±3.4)分,(P<0.05]均显著较低,而个人痛苦[(8.8±5.1)分,(6.5±3.7)分,(P<0.01]则显著较高.WCST、Stroop测验和空间n-back测验各项评分,2组间差异具有显著性意义(均P<0.01).Pearson相关分析显示,IRI-C总分与WCST卡片分类测验的总应答数(r=-0.293)、错误应答数(r=-0.253)和非持续性错误数(r=-0.272)呈负相关(均P<0.05),共情关心分与WCST总应答数(r=-0.326,P<0.01)、错误应答数(r=-0.300,P<0.01)、持续性应答数(r=-0.294,P<0.01)和持续性错误数(r=-0.287,P<0.05)呈负相关,而与概念化水平数呈正相关(r=0.279,P<0.05);IRI-C的幻想力分与Stroop测验的B项(r=-0.299)和C项(r=-0.322)反应时存在负相关(均P<0.01).结论 精神分裂症患者存在广泛共情和执行功能障碍,情感共情水平与执行功能存在某种关联,提示执行功能障碍可能构成患者共情缺陷的病理机制之一.

An association study of empathy and executive function in schizophrenic patients

Objective To investigate the empathic abilities and the association between empathic abilities and executive function in schizophrenic patients. Methods Empathy with the Interpersonal Reactivity Index-C (IRI-C) and executive function with Wisconsin Card Sorting Test (WCST) , Stroop Color-Word Task (Stroop), Spatial n-back Task (n-back) were applied to 74 schizophrenic patients and 69 healthy controls. Results Compared with healthy controls, schizophrenic patients showed significantly lower total scores ((46. 8 ± 10. 0) vs (51.5 ±9.7), P<0.01),and subscores in Perspective Taking ((9.5 ±4.2) vs (12.2 ±3.9) , P<0. 01), Fantasy ((12.5 ±4.2) vs (15.5 ±3.8), P<0.01) and Empathic Concern((15. 9 ±4.2) vs (17. 3 ±3.4), P< 0.05) ,but higher subscore((8.8 ±5. 1) vs (6.5 ±3.7), P<0.01) in personal distress of IRI-C. A significant difference(P<0.01) were fund on the scores of WCST, Stroop task and n-back task between schizophrenic patients and healthy controls. Pearson correlation analysis showed that the total scores of IRI-C was negatively correlated with the response administered (Ra), the number of responses errors (Re) and non-perseverative errors (nRpe) of WCST (r= -0.293, r= -0.253, r= -0.272, P<0.05) respectively, that empathic concern sub-score of IRI-C was negatively correlated with Ra, Re, perseverative responses (Rp) and perseverative errors (Rpe) of WCST (r= -0.326, r= -0.300, r= -0.294, r= -0.287, P<0.01 -0.05) respectively , but positively correlated with Rfp. of WCST (r=0.279, P<0.05), and that the fantasy subscore of IRI-C was negatively correlated with the reaction time of B part(r= -0.299, P<0.01) and C part (r= -0.322, P<0.01) of the Stroop task. Conclusion Schizophrenics have a general impairment of empathy and executive function,and affective empathy is related to the executive function, suggesting that the impairment of executive function maybe the one of pathological mechanism for the empathic deficit of patients with schizophrenia.