首发精神分裂症关系妄想症状的神经认知病理改变  

Potential Pathological Basis of Neurocognition in First Episode Schizophrenia Patients with Delusion of Reference as Prominent Positive Symptom

作　　者：范泽斌 苟宁芝 黄凯茵 吴国伟[1] 王政[1] 蒲唯丹[3] 刘哲宁[1] 陶好娟[1] FAN Ze-bin;GOU Ning-zhi;WONG H.Y Gloria;WU Guo-wei;WANG Zheng;PU Wei-dan;LIU Zhe-ning;TAO Hao-juan(Mental Health Institute of the Second Xiangya Hospital,Central South University,The China National Clinical Research Center for Mental Health Disorders,National Technology Institute of Psychiatry,Key Laboratory of Psychiatry and Mental Health of Hunan Province,Changsha 410011,China;Department of Social Work and Social Administration,University of Hong Kong,Hong Kong 999077,China;Psychological Center,the Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院精神卫生研究所国家精神心理疾病临床研究中心精神疾病诊疗技术国家地方联合工程实验室精神病学与精神卫生湖南省重点实验室,长沙410011 [2]香港大学社会工作及社会行政学系,中国香港999077 [3]中南大学湘雅二医院医学心理中心,长沙410011

出　　处：《中国临床心理学杂志》2018年第5期927-932,共6页Chinese Journal of Clinical Psychology

基　　金：国家自然科学基金青年科学基金项目(项目批准号:81301161)

摘　　要：目的:对关系妄想(DOR)可能的神经认知机制进行研究。方法:入组首发精神分裂症患者43例,其中关系妄想组(DOR组)15例,非关系妄想组(Non-DOR)28例;另入组健康对照(HC)47例。采用轮廓整合测验、Babble测验测试所有受试者的听觉、视觉信号的组织能力。结果:DOR组在Babble测验中其正确词数与错词数目与Non-DOR组和HC无明显差异(P>0.05),而错词长度显著高于HC和Non-DOR组(P<0.05);DOR患者的轮廓整合能力较HC整体上未发现明显下降(P>0.05),但在随机测验25°水平的错误得分上,显著高于HC(P<0.05)且与牵连观念访谈量表得分呈显著正相关(r=0.239,P=0.023)。结论:以DOR为主要临床表现的首发精神分裂症患者对听觉和视觉水平的无关信息的过度提取可能是DOR的神经认知的病理基础。Objective： To explore the potential neurocognitive mechanism of delusion of reference（DOR） in first episode schizophrenia patients with delusion of reference as prominent positive symptom. Methods： Forty-three patients with first episode schizophrenia including 15 patients in DOR group and 28 patients in Non-DOR group and 47 health controls（HC） were recruited in the present study. Babble task and Contour integration test were used to test the auditory and visual per- ceptual organization abilities of all participants. Results： In Babble task, the length of wrong words in DOR group was sig- nificantly higher than HC group and Non-DOR group（P〈0.05）, while the number of correct words and wrong words showed no significant difference among the three groups（P〉0.05）. There was no significant decrease in overall contour integration abilities of DOR groups compared with HC groups（P〉O.05）. However, DOR groups showed significantly higher wrong score on the 25 degree level in Randomized Set compared to HC group（P〈O.05）. Furthermore, the wrong scores on the 25 degree level in Randomized Set correlated significantly to the total score of Ideas of Reference Interview Scale（r=0.239, P=0.023）. Conclusion： Excessive extraction of irrelevant information may underpin the pathological basis of neurocognition in first episode schizophrenia patients with DOR as prominent positive symptom.

关 键 词：牵连观念 关系妄想 首发精神分裂症 神经认知 

分 类 号：R395.2[哲学宗教—心理学]