前瞻性记忆两种测量方法对老年精神分裂症患者诊断效度的比较  

Comparison of two measures assessing prospective memory impairment in elderly people with schizophrenia

作　　者：郜肖肖[1] 邹义壮[1] 陈楠[1] 范宏振[1] 温玉杰[1] 刘礼丽 

机构地区：[1]北京大学北京回龙观医院,北京100096

出　　处：《中国心理卫生杂志》2015年第7期516-521,共6页Chinese Mental Health Journal

基　　金：首都医学发展科研基金项目(计算机认知矫正治疗对老年轻度认知障碍的干预研究;2009-1056);北京市科技计划项目(CRT改善精神分裂症患者认知功能的研究及机制探讨;编号D0906001040191)

摘　　要：目的:探讨前瞻性记忆(PM)两种评估方法 (实验室范式和中文版剑桥前瞻性记忆测验)在老年及老年前期精神分裂症患者临床应用上的差异和诊断效度。方法:选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)精神分裂症诊断标准的老年及老年前期患者50例,以及年龄、性别、受教育年限相匹配的正常被试50例。以双重任务前瞻性记忆实验室范式和计算机版中文剑桥前瞻性记忆测试量表(C-CAMPROMPT)分别评估基于事件的前瞻性记忆(EBPM)、基于时间的前瞻性记忆(TBPM);采用韦克斯勒成人智力记忆量表第四版中文版(WAIS-IV)、持续注意测验分别评估智力和注意力。结果:实验室范式和C-CAMPROMPT的结果均显示,患者组的前瞻性记忆总分PM[7(0,16)vs.12(0,16),14(4,34)vs.25(11,36)],EBPM[3(0,8)vs.6(0,8),7(2,16)vs.14(4,18)]和TBPM[3(0,8)vs.6(0,8),6(2,18)vs.12(4,18)]得分均低于对照组(均P﹤0.001)。患者组用两种方法评估EBPM与TBPM损害指数[-1.0(-2.2,1.0)vs.-1.0(-2.1,0.8),-1.9(-3.4,0.8)vs.-1.8(-2.9,1.6)]的差异均无统计学意义(均P>0.05)。相关分析显示,实验室范式PM得分与年龄相关无统计学意义(P>0.05);而C-CAMPROMPT的PM得分与年龄呈负相关(r=-0.36^-0.40,P﹤0.001)。实验室范式和C-CAM PROM PT的ROC曲线下面积分别为0.73和0.85;灵敏度分别为0.60和0.74;特异度分别为0.76和0.90。结论:两种方法均显示老年及老年前期精神分裂症患者的EBPM与TBPM损害程度相当,且均具有中等程度的诊断效度,但C-CAM PROM PT诊断效度略高,其成绩也可能更易受年龄老化的影响。Objective： To compare the results of two different measures assessing prospective memory （PM） in elderly schizophrenia, and explore their diagnostic validity. Methods： Fifty patients who were diagnosed as schizophrenia according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition （DSM- IV） and 50 normal elderly people were enrolled in the study. Laboratory paradigm prospective memory task and the Chinese version of the Cambridge prospective memory Test （C-CAMPROMPT） were administered to measure thelevel of EBPM and TBPM. The Wechsler Adult Intelligence Scale-Fourth Edition, Continuous Performance Test-I- dentical Pairs were used to evaluate IQ and attention. Results： Whether in the laboratory paradigm or C-CAMPROMPT, schizophrenia group performed worse than normal controls on PM total scores[7（0, 16）vs. 12（0, 16）, 14 （4, 34） vs. 25（11,36） ], EBPM[3（0, 8） vs. 6（0, 8）, 7（2, 16） vs. 14（4, 18） ] and TBPM [ 3（0, 8） vs. 6（0, 8）, 6（2, 18） vs. 12（4, 18）], and patients had comparable performances in PM subtypes[ -1.0（ -2. 2, 1.0）vs. -1.0（ -2. 1, 0. 8）, - 1.9（ -3.4,0. 8）vs. - 1.8（ -2.9, 1.6）]. In the C-CAMPROMPT, the scores of EBPM and TBPM were negatively related to age（r = -0. 36 - - 0. 40, P 〈 0. 001）, but there was no significant relationship between PM performance and age in the laboratory paradigm task. The area under ROC curve of the laboratory paradigm and CCAMPROMPT were 0. 73 and 0. 85. While 8 and 19 as the cut off value, the sensitivity were 0. 60 and 0.74, and the specificity were 0. 76 and 0. 90, respectively. Conclusion： The two measures have confirmed that the elderly schizophrenia have comparable performances in EBPM and TBPM. Both the C-CAMPROMPT and the laboratory paradigm have moderate level of diagnostic validity, but the former is slightly higher and more susceptible to aging.

关 键 词：精神分裂症 前瞻性记忆 实验室范式 C-CAMPROMPT 诊断效度 横断面研究 

分 类 号：R749.3[医药卫生—神经病学与精神病学] B842.3[医药卫生—临床医学]