心理理论能力在稳定期精神分裂症精神症状与社会功能之间的中介作用  

The mediating effect of theory of mind between psychotic symptoms and social functioning in stable schizophrenia

作　　者：仲捷 朱虹 郝军[1,2] 贾竑晓 Zhong Jie;Zhu Hong;Hao Jun;Jia Hongxiao(The National Clinical Research Center for Mental Disorders&Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京安定医院国家精神心理疾病临床医学研究中心精神疾病诊断与治疗北京市重点实验室,北京100088 [2]首都医科大学人脑保护高精尖创新中心,北京100069

出　　处：《首都医科大学学报》2023年第4期590-595,共6页Journal of Capital Medical University

基　　金：北京市医院管理中心临床医学发展专项(ZYLX202129);北京市医院管理中心“登峰”人才培养计划项目(DFL20191901)。

摘　　要：目的探讨稳定期精神分裂症患者的心理理论能力在精神症状与社会功能之间的中介作用。方法选用阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)评估稳定期精神分裂症患者的精神症状;选取3种测试评估患者的神经认知功能:威斯康星卡片分类测验中的完成分类数、持续性操作测验平均反应时间、韦氏成人智力量表中的数字广度项目;选取4个心理理论能力任务评估患者的社会认知:一级错误信念、二级错误信念、失言识别任务和眼区阅读测试;选用个人与社会功能量表(Personal and Social Functioning Scale,PSP)评估精神分裂症患者的社会功能。分析稳定期精神分裂症患者的心理理论能力在精神症状与社会功能之间的中介效应。结果PSP结果分别与患者的阴性症状呈负相关(r=-0.453,P<0.001)、与失言任务评分呈正相关(r=0.544,P=0.010),失言任务评分与阴性症状呈负相关(r=-0.331,P<0.001),阴性症状对社会功能有直接效应(β=-0.467,t=-0.461,P<0.01),失言任务在阴性症状和社会功能之间有一定的中介作用(β=0.410,t=3.529,P<0.01)。结论稳定期精神分裂症患者的社会功能损害与阴性症状及心理理论能力密切相关。失言任务在患者精神症状与社会功能间存在中介作用。Objective To investigate the mediating role of theory of mind between psychotic symptoms and social functioning in stable schizophrenia patients.Methods Positive and negative syndrome scale(PANSS)was applied to assess patients psychiatric symptoms.The number of completed categories on the Wisconsin Card Sorting Test(WCST),the mean response time on the Continuous Performance Test(CPT),and the breadth of numbers on the Wechsler Adult Intelligence Scale(WAIS)were used to assess the general cognitive function of the patients.Four theory of mind tasks were selected to assess patients social cognition:the first-order false belief,the second-order false belief,the faux-pas task,and the reading the mind in eyes test.The Personal and Social Functioning Scale(PSP)was selected to assess the social functioning of patients with schizophrenia.Results PSP scores were negatively correlated with patients negative symptoms(r=-0.453,P<0.001),positively correlated with faux-pas task scores(r=0.544,P=0.010).The faux-pas task scores were negatively correlated with negative symptoms(r=-0.331,P<0.001),and negative symptoms had a direct effect on social functioning(β=-0.470,P<0.01).There was a mediating effect of the aphasia task(β=0.407,P<0.01).Conclusions Impairment of social functioning in patients with stable schizophrenia is closely related to negative symptoms and social cognition.The faux-pas task partially mediates patients psychiatric symptoms and social functioning.

关 键 词：精神分裂症 认知功能 社会功能 中介作用 

分 类 号：R749.3[医药卫生—神经病学与精神病学]