精神分裂症患者童年创伤与认知功能的相关性  

Correlation of childhood trauma and cognitive function in patients with schizophrenia

作　　者：方文梅 朱道民 赵子丛[2] 马玉婷[2] 赵菁[2] 王安珍 程夏龙 张博宇 汪凯[3] 董毅 Fang Wenmei;Zhu Daomin;Zhao Zicong;Ma Yuting;Zhao Jing;Wang Anzhen;Cheng Xialong;Zhang Boyu;Wang Kai;Dong Yi(Psychology Department,Affiliated Psychological Hospital of Anhui Medical University,Hefei Fourth Peopled Hospital,Anhui Mental Health Center,Hefei 230022,China;Medical Psychology Department,Anhui Medical University,Hefei 230032,China;Neuropsychology Labomtory,Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学附属心理医院,合肥市第四人民医院,安徽省精神卫生中心心理科,合肥230022 [2]安徽医科大学医学心理学系,合肥230032 [3]安徽医科大学神经心理研究室,合肥230032

出　　处：《中华行为医学与脑科学杂志》2020年第11期995-1000,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金项目(81171273)。

摘　　要：目的探讨精神分裂症患者童年创伤与认知功能的关系。方法选取安徽省精神卫生中心住院和门诊的精神分裂症患者62例(患者组)和社区健康对照63例(对照组)。采用童年创伤问卷(childhood trauma questionnaire,CTQ)、威斯康星卡片分类测验(Wisconsin card sorting test,WCST)、注意网络功能测验(attention network test,ANT)、言语流畅性测验(verbal fluency test,VFT)和数字广度测验(digit span test,DST)对所有被试进行评估。采用SPSS 17.0软件进行统计学分析,正态分布的计量资料组间比较采用t检验;非正态分布的计量资料组间比较采用Mann-WhitneyU检验。CTQ分与认知功能分间的关系采用Spearman相关分析。结果患者组CTQ总分、情绪虐待、躯体虐待、性虐待、情绪忽视和躯体忽视因子分[48.50(37.75,57.00)分,9.00(6.00,12.25)分,7.00(5.00,9.25)分,5.50(5.00,7.25)分,13.00(9.00,16.25)分,11.00(8.00,13.00)分]均高于对照组[34.00(30.00,37.00)分,6.00(5.00,7.00)分,5.00(5.00,5.00)分,5.00(5.00,5.00)分,9.00(6.00,11.00)分,7.00(6.00,10.00)分],差异有统计学意义(Z=-4.781^-6.724,均P<0.01)。与对照组相比,患者组WCST完成分类数减低,而错误应答数、持续应答数和持续性错误数升高(Z=-5.655^-6.060,均P<0.01);ANT正确率降低,而反应时增长(Z=-5.796,-6.094,均P<0.01);VFT和DST分均降低(Z=-3.492^-8.499,均P<0.01)。相关分析显示,患者组CTQ性虐待分与WCST完成分类数(r=-0.384)呈负相关,与错误应答数(r=0.360)、持续应答数(r=0.394)及持续性错误数(r=0.381)间呈正相关(均P<0.01);CTQ躯体忽视分与ANT正确率(r=-0.400)和执行控制分(r=-0.417)间呈负相关,情绪忽视分与VFT分间呈负相关(r=-0.345)(均P<0.01),控制年龄、受教育年限和PANSS总分后,这种相关性仍存在。结论精神分裂症患者早年经历创伤性事件较多,存在广泛的认知功能缺陷,童年创伤对患者认知灵活性、注意、记忆和言语功能具有负性影响,但患者童年创伤Objective:To explore the relationship between the childhood trauma and neruocognition in patients with schizophrenia.Methods:Sixty-two patients with schizophrenic were selected from Anhui mental health center,and sixty-three community health controls were selected.All subjects were assessed with the childhood trauma questionnaire(CTQ),Wisconsin card sorting Test(WCST),attention network test(ANT),verbal fluency test(VFT)and digit span test(DST).SPSS 17.0 was used for statistical analysis.t-test was used to compare the measurement data of normal distribution and Mann-Whitney U test was used to compare the measurement data of non-normal distribution.Spearman correlation analysis was used to analyze the relationship between CTQ score and cognitive function score.Results:Compared with health controls(34.00(30.00,37.00),6.00(5.00,7.00),5.00(5.00,5.00),5.00(5.00,5.00),9.00(6.00,11.00),7.00(6.00,10.00)),the total score of CTQ,subscores of emotional abuse,physical abuse,sexual abuse,emotional neglect and physical neglect in patients with schizophrenia were significantly increased(48.50(37.75,57.00),9.00(6.00,12.25),7.00(5.00,9.25),5.50(5.00,7.25),13.00(9.00,16.25),11.00(8.00,13.00))(Z=-4.781--6.724,all P<0.01).Compared with the control group,the number of WCST classification completed in the patient group was lower,while the number of wrong answers,continuous answers and persistent errors increased(Z=-5.655--6.060,all P<0.01).The correct rate of ant decreased,but the reaction time increased(Z=-5.796,-6.094,all P<0.01).VFT and DST scores were decreased(Z=-3.492--8.499,both P<0.01).In patients with schizophrenia,CTQ sexual abuse subscore were negatively correlated with completed categories scores(r=-0.384)and positively correlated with total errors(r=0.360),perseverative responses(r=0.394)and perseverative errors(r=0.381)on WCST(all P<0.01).CTQ physical neglect scores were negatively correlated with the ANT correct ratio(r=-0.400)and conflict resolution(r=-0.417)(all P<0.01).CTQ emotional neglect scores were negatively corr

关 键 词：精神分裂症 童年创伤 认知功能 注意 记忆 

分 类 号：R749.3[医药卫生—神经病学与精神病学]