首发缺陷型与非缺陷型精神分裂症临床症状和神经认知损伤的研究  

The clinical symptoms and neurocognitive impairment of first-episode deficit and nondeficit subtype of schizophrenia

作　　者：王浩然 王德权 李坤 冉娅 张雅敏 邓伟 Wang Haoran;Wang Dequan;Li Kun;Ran Ya;Zhang Yamin;Deng Wei(Mental Health Center,West China Hospital,Sichuan University,Chengdu 610041,China;Affiliated Mental Health Center&Hangzhou Seventh People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310000,China)

机构地区：[1]四川大学华西医院心理卫生中心,成都610041 [2]浙江大学医学院附属精神卫生中心(杭州市第七人民医院),杭州310000

出　　处：《中华行为医学与脑科学杂志》2023年第4期302-307,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：杭州市生物医药和健康产业扶持科技专项 (2021WJCY067,2021WJCY194)。

摘　　要：目的比较首发缺陷型精神分裂症(first-episode deficit subtype of schizophrenia,FDS)患者和首发非缺陷型精神分裂症(first-episode nondeficit subtype of schizophrenia,FNDS)患者精神病性症状和神经认知功能的差异。方法于2021年1—9月在四川大学华西医院心理卫生中心门诊或病房招募首发未治疗的精神分裂症患者,通过缺陷型精神分裂症诊断量表(schedule for the deficit syndrome,SDS)将患者分为缺陷型(FDS组,n=44)和非缺陷型(FNDS组,n=44)。同时在社区招募44名健康对照(healthy controls,HC组)。采用阳性和阴性症状量表(positive and negative syndrome scale,PANSS)评估患者精神病性症状,采用韦氏成人智力测试(Wechsler adult intelligence scale,WAIS-RC)、连线测验和逻辑记忆测试评估所有被试的智商和神经认知功能。运用SPSS 22.0软件进行统计分析,采用独立样本t检验,单因素方差分析比较符合正态分布的变量,采用Mann-Whitney秩和检验和Kruskal-Wallis秩和检验比较不符合正态分布的变量。结果(1)FDS组和FNDS组的精神病性症状存在明显差异:与FNDS组相比,FDS组的PANSS总分[(95.95±16.82)分比(88.39±16.29)分]、阴性症状分[(27.57±7.52)分比(16.57±5.76)分]和反应缺乏因子分[(13.43±3.82)分比(7.00(5.00,9.00)分]更高(均P<0.05),而阳性症状分[(21.95±6.88)分比(25.41±6.07)分]、激活性因子分[8.00(5.00,9.00)分比(9.27±3.47)分]、抑郁因子分[5.50(4.00,9.00)分比(8.00(6.00,12.00)分]和补充项目分[(13.60±4.17)分比(17.30±5.39)]更低(均P<0.05)。(2)FDS组和FDNS组的神经认知功能存在差异,且比HC组更差:FDS组的空间记忆分[木块图测试:(23.70±11.05)分比(31.72±11.49)分]和信息处理速度分[数字符号测试:(38.38±15.85)分比(47.97±14.99)分]显著低于FNDS组(均P<0.05);FDS组和FNDS组的智商、信息处理速度分和空间记忆分等指标均低于HC组(均P<0.05)。结论首发缺陷型精神分裂症相较于非缺陷型,具有更严重�Objective To ulteriorly explore the differences of psychotic symptoms and neurocognitive between patients with first-episode deficit subtype of schizophrenia(FDS)and patients with first-episode nondeficit subtype of schizophrenia(FNDS).Methods From January 2021 to September 2021,a total of 88 first-episode treatment-naive schizophrenia were recruited from the Mental Health Center of West China Hospital and divided into FDS group(n=44)and FNDS group(n=44)according to the schedule for the deficit syndrome(SDS),and 44 healthy subjects were included as healthy control group(HC group,n=44).Positive and negative syndrome scale(PANSS)was used to assess psychotic symptoms of patients and Wechsler adult intelligence scale,trail making test and logic memory test were used to evaluate intelligence quotient and neurocognitive function of all subjects.SPSS 22.0 was used for statistical analysis,and independent samples t-test and one-way analysis of variance(ANOVA)were used to compare variables that met normal distribution,while the Mann-Whitney U test and Kruskal-Wallis H test were used to compare variables that did not meet normal distribution.Results(1)There were significant differences in psychotic symptoms between the FDS group and the FNDS group.Compared with the FNDS group,the FDS group had higher total score of PANSS((95.95±16.82)vs(88.39±16.29)),negative symptoms((27.57±7.52)vs(16.57±5.76))and anergastic reaction((13.43±3.82)vs(7.00(5.00,9.00)),and lower positive symptoms scores((21.95±6.88)vs(25.41±6.07)),activation((8.00(5.00,9.00)vs(9.27±3.47)),depression((5.50(4.00,9.00)vs(8.00(6.00,12.00))and supplementary item((13.60±4.17)vs(17.30±5.39))(all P<0.05).(2)There were differences in neurocognitive functions between FDS group and FNDS group,and which in FDS and FNDS group were worse than that in HC group.Spatial memory(block design test:(23.70±11.05)vs(31.72±11.49))and information processing speed(digit symbol test:(38.38±15.85)vs(47.97±14.99))of FDS group were significantly lower than those of FNDS grou

关 键 词：首发精神分裂症 缺陷型症状 神经认知 空间记忆 信息处理速度 

分 类 号：R749.3[医药卫生—神经病学与精神病学]