儿童青少年期起病精神分裂症患者的临床特征与认知功能的关系  

Relationship between clinical features and cognitive function in patients with childhood and adolescence-onset schizophrenia

作　　者：曹阳[1] 康传媛[1] 万帅[1] 都萌萌 丁凯景[1] 李雪蓉[1] 

机构地区：[1]昆明医科大学第一附属医院精神科,云南昆明650032

出　　处：《中国当代儿科杂志》2015年第4期379-383,共5页Chinese Journal of Contemporary Pediatrics

基　　金：国家自然科学基金(编号:81460218);云南省高层次卫生技术人才培养专项经费(编号:D-201238);2012云南省卫生科技计划项目(2012ws0008)

摘　　要：目的探讨儿童青少年期起病精神分裂症患者认知功能的影响因素。方法对符合国际疾病分类第十版精神分裂症诊断标准的78名儿童青少年期起病的精神分裂症患者的临床资料进行回顾性分析。采用韦氏儿童智力测验、倒背数字、威斯康星卡片分类测验(WCST)以及P300等评估认知功能,使用阳性与阴性症状量表(PANSS)评定临床症状。结果患者的受教育年限越长,P300Fz点P3潜伏期越短;患者发病年龄越早,P300Fz点P3波潜伏期越长;患者母亲受教育年限越长,患者的IQ总分、言语IQ分、操作IQ分、WCST概念化水平百分数以及倒背分数越高;父亲受教育年限越长,患者的WCST概念化水平百分数和WCST完成分类数越高;PANSS阴性症状分量表得分高者IQ总分低、言语IQ分低、操作IQ分低、WCST概念化水平低、WCST完成分类数少以及倒背分数低,PANSS抑郁分高者倒背分数低,PANSS总分高者WCST完成分类数少以及倒背分数低;疾病稳定时间长者倒背分数高。结论阴性症状严重程度及父母受教育程度是儿童青少年期起病精神分裂症患者认知功能的主要影响因素。Objective To explore the factors influencing cognitive functions in patients with childhood and adolescence-onset schizophrenia. Methods The clinical data of 78 patients with childhood and adolescence-onset schizophrenia who met with the criteria of ICD-10 for schizophrenia were retrospectively reviewed. The cognitive functions were evaluated by the Chinese Wechsler Intelligence Scale for Children（C-WISC）, the Wisconsin Card Sorting Test（WCST）, digit span backward and P300. The clinical symptoms were evaluated by the Positive and Negative Syndrome Scale（PANSS）. Results The patients with a lower education level or earlier onset of age had a longer P3 latency at the P300 Fz area. The patients with a higher parental education level had higher scores of full intelligence quotient（FIQ）, verbal intelligence quotient（VIQ）, performance intelligence quotient（PIQ）, conceptual level and completed categories of WCST and backward numeric order reciting. The patients with higher PANSS negative subscale scores had lower scores of FIQ, VIQ, PIQ, completed categories and conceptual level of WCST and backward numeric order reciting. The patients with a longer stabilization time had higher backward numeric order reciting scores. Conclusions The severity of negative symptoms of the patients and the educational level of their parents are major factors influencing cognitive functions in patients with childhood and adolescence-onset schizophrenia.

关 键 词：精神分裂症 认知功能 临床特征 儿童青少年 

分 类 号：R749.3[医药卫生—神经病学与精神病学]