住院精神分裂症患者韦氏成人智力测验第四版中文版测评的智力特征  

Intellectual characteristics measured with the Chinese version of the Wechsler Adult Intelligence Scale-Fourth Edition in patients with schizophrenia

作　　者：何雪玲[1] 王健[1] 崔界峰[1] 范宏振[1] 陈楠[1] 姚晶[1] 段京辉[1] 晏丽娟[2] 陈娆[2] 江雪[1] 

机构地区：[1]北京大学北京回龙观医院教学医院,北京100096 [2]河北联合大学公共卫生学院,河北唐山063000

出　　处：《中国心理卫生杂志》2013年第11期858-863,共6页Chinese Mental Health Journal

摘　　要：目的:探讨精神分裂症患者韦氏成人智力测验第四版(WAIS-IV)中文版测评结果反映的智力特征及其可能的相关因素。方法:选取符合国际疾病和相关健康问题统计分类第十版(ICD-10)精神分裂症诊断标准的患者120例及正常对照120例,以WAIS-IV中文版评定两组的智力状况,以阳性与阴性症状量表(PANSS)评定患者的临床症状,并收集患者的受教育程度、发病年龄、病程和疾病分型资料。参照WAIS-IV智商等级划分标准将患者分为平常以上、平常以下和智力缺陷三组。结果:55.8%的精神分裂症患者的智力水平在平常以上,24.2%在平常以下,20%属于智力缺陷。精神分裂症组的WAIS-IV总智商[(91.2±17.4)vs.(106.7±13.3)]、加工速度指数[(80.4±17.1)vs.(104.5±13.3)]、工作记忆指数[(93.4±17.2)vs.(106.9±14.1)]、知觉推理指数[(90.9±18.5)vs.(103.2±13.9)]和言语理解指数[(101.2±16.7)vs.(107.7±13.1)]的得分均低于正常对照组(均P<0.001)。进行效应量比较发现,患者的加工速度指数(Cohen's d=1.58)得分与正常对照相比差异最大,其次是工作记忆指数(Cohen's d=0.86)、知觉推理指数(Cohen's d=0.70)得分,而言语理解指数得分(Cohen's d=0.44)差异最小。逐步线性回归分析显示,患者WAIS-IV中文版总智商与PANSS阴性症状分呈反比(β=-0.40,P<0.05),与受教育年限呈正比(β=0.59,P<0.01)。结论:使用WAIS-IV中文版评估发现精神分裂症患者存在智力损害,尤其在加工速度和工作记忆方面受损较重。精神分裂症患者的阴性症状越重、受教育程度越低,智商可能越低。Objective：To explore the performance characteristics on the Chinese version of the Wechsler Adult Intelligence Scale-Fourth Edition （WAIS-Ⅳ） in patients with schizophrenia.Methods：Totally 120 patients with schizophrenia and 120 age,gender and education level matched normal subjects were enrolled in the study.The diagnosis was made according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision （ICD-10）.The Positive and Negative Syndrome Scale （PANSS） were used to assess clinical symptoms in the patients,and the data about course,education years,age of onset,and disease subtype were collected.The Chinese version of the WAIS-Ⅳ was used to assess the intelligence quotient （IQ）.Results：In patients with schizophrenia,55.8% of them were with the IQ of above normal,24.2% with the IQ of below normal,and 20% suffered intelligence deficiency.The full scale intelligence quotient （FSIQ） [（91.2 ± 17.4） vs.（106.7 ± 13.3）],processing speed index （PSI） [（80.4 ± 17.1） vs.（104.5 ± 13.3）],working memory index （WMI） [（93.4 ±17.2） vs.（106.9 ± 14.1）],perceptual reasoning index （PRI） [（90.9 ± 18.5） vs.（103.2 ± 13.9）],verbal comprehension index （VCI） [（101.2 ± 16.7） vs.（107.7 ± 13.1）] were lower in patients than controls （Ps 〈 0.01）.The results of effect size indicated that PSI （Cohen＇s d =1.58） had the biggest difference,WMI （Cohen＇s d =0.86）and PRI （Cohen＇s d=0.70） came second,and VCI （Cohen＇s d =0.44） had the smallest difference between the two groups.Multiple stepwise regression analysis showed that the FSIQ of the patients with schizophrenia were negatively correlated with the scores of negative symptoms （β =-0.40,P 〈0.05） and positively correlated with the education years （β =0.59,P 〈0.01）.Conclusion：It suggests that there may be intelligence impairments in patients with schizophrenia,especially in processing speed and working memory.The patie

关 键 词：精神分裂症 智力 WAIS-Ⅳ中文版 认知功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学] B841.7[医药卫生—临床医学]