精神分裂症患者症状特征与认知功能的关系
Relationship between clinical features and cognitive function of patients with schizophrenia

摘要：目的 探讨精神分裂症患者认知损害与阳性和阴性症状量表(positive and negative syndrome scale, PANSS)5因子模型之间的关系。方法 选取首发或者复发未治疗住院的精神分裂症患者130名和85名健康对照，采用精神分裂症认知功能成套测验中文版(MATRICS consensus cognitive battery, MCCB)评估2组的认知功能，PANSS量表5因子模型评估患者的精神症状。结果 患者组在MCCB测量的连线、符号编码、言语流畅、霍普金斯词语学习、空间广度、空间记忆、迷宫及情绪管理分测验评分均低于对照组(P<0.001)；患者组在MCCB评估的认知维度与PANSS 5因子模型的关联性分析中，认知损害因子与信息处理加工速度、言语学习、推理及问题解决、社会认知能力均呈负相关(P<0.050)，而其他因子与MCCB评估的认知维度均无相关。结论 精神分裂症患者认知功能不同程度受损,其中信息处理加工速度受损程度更为严重；精神分裂症患者认知功能与阴性症状是相互独立的症状群，在患者治疗过程中，需要制定不同的方案。
ABSTRACT: Objective To investigate the relationship between the 5 Positive and Negative Syndrome Scale (PANSS) factors of a recent consensus model and cognitive performance in patients with schizophrenia. Methods Totally 130 inpatients and 85 healthy controls matched for age, gender and education were recruited. The MATRICS Consensus Cognitive Battery (MCCB) was used to evaluate cognitive function. PANSS was used to evaluate symptoms. Results Compared with those of the controls, scores of TMT, BACS, Fluency, WMS, HVLT-R, BVMT-R, NBA and MSCEIT tests in MCCB were lower in the patients (all P<0.001). The PANSS cognitive factor showed a small to moderate significant association with MCCB speed of processing, verbal learning, reasoning and problem solving and social cognition (all P<0.050). Notably, however, no relationship was found between the other PANSS factors and any of the MCCB scores. Conclusion There are a wide range of cognitive function impairments in patients with schizophrenia. These results support the relative independence of cognition from other domains of psychopathology, including negative symptoms, in patients with schizophrenia. Therefore, we need to make different kinds of plans when treating patients