童年创伤对精神病临床高危个体认知功能的影响  

The impact of childhood trauma on cognitive function in individuals with clinical high risk of psychosis

作　　者：丁玉深 董芳[2] 侯文鹏 王传跃 Ding Yushen;Dong Fang;Hou Wenpeng;Wang Chuanyue(Beijing Key Laboratory for the Diagnosis and Treatment of Mental Disorders,Beijing Anding Hospital Affiliated to Capital Medical University,Beijing 100088,China;The 10th Ward of Psychiatry Department,Beijing Anding Hospital Affiliated to Capital Medical University,Beijing 100088,China)

机构地区：[1]首都医科大学附属北京安定医院,精神疾病诊断与治疗北京市重点实验室,北京100088 [2]首都医科大学附属北京安定医院精神科十病区,北京100088

出　　处：《中华行为医学与脑科学杂志》2023年第8期688-693,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金(81971250);北京市卫健委高层次公共卫生技术人才培养计划学科骨干(2022-3-014);北京市医院管理中心青年人才培养"青苗"计划(QML20191904)。

摘　　要：目的探讨精神病临床高危个体(clinical high risk of psychosis,CHR)认知功能与童年创伤的特点,以及两者之间的关系。方法2017年6月到2022年9月在北京安定医院,使用精神病风险综合征结构化访谈(structured interviews with psychiatric risk syndrome,SIPS)筛选得到CHR个体62例(CHR组),同时招募性别、年龄及受教育年限相匹配的健康对照61例(健康对照组)。使用童年创伤问卷(childhood trauma questionnaire,CTQ)和MATRICS共识认知成套测验(MATRICS consensus cognition test,MCCB)中文版对所有被试进行评估。使用R4.1.1软件比较两组人群认知功能和童年创伤的差异,并分析CHR组认知功能和童年创伤的相关性。结果CHR组的认知总分[(41.46±6.97)分]、信息处理速度[(40.20±8.40)分]、注意警觉性[(40.92±11.00)分]、工作记忆[(41.09±9.97)分]、词语学习和视觉学习维度分均低于健康对照[认知总分(46.26±7.64)分,信息处理速度(45.83±8.36)分,注意警觉性(46.30±9.57)分,工作记忆(46.18±9.49)分],差异有统计学意义(t=-3.73~-2.03,P<0.05)。CHR组的CTQ总分、情感虐待、躯体虐待、躯体忽视因子分[40.0(36.0,50.8)分,7.5(6.0,10.0)分,5.0(5.0,7.0)分,9.0(7.0,11.0)分]显著高于健康对照组[34.0(31.0,40.0)分、6.0(5.0,8.0)分,5.0(5.0,6.0)分,9.0(6.0,10.0)分](Z=-4.07~-2.06,均P<0.05)。CHR组的童年创伤总分及躯体虐待因子分与工作记忆存在负相关(r=-0.29,-0.28,P<0.05),躯体忽视与认知功能总分、注意警觉性及词语学习之间存在负相关(r=-0.28,-0.26,-0.31,P<0.05)。以性别、年龄、受教育年限、SIPS总分为协变量,进行偏相关分析,前述相关关系仍显著。结论CHR个体存在多领域的认知受损,童年创伤情况更严重,童年创伤特别是躯体创伤可能影响CHR个体的认知功能。Objective To explore the impact of cognitive function and childhood trauma in individuals with clinical high risk of psychosis(CHR).Methods From June 2017 to September 2022,a total of 62 individuals with CHR(CHR group)were screened by structured interviews with psychiatric risk syndrome(SIPS)at Beijing Anding Hospital,and 61 healthy controls(healthy control group)matched in gender,age,and educational years were recruited.All participants were evaluated by the childhood trauma questionnaire(CTQ)and the Chinese version of the MATRICS consensus cognitive test battery(MCCB).Differences in cognitive function and childhood trauma between the two groups were compared by R4.1.1 software,and the correlation between cognitive function and childhood trauma in the CHR group was analyzed.Results The scores of MCCB composite score(41.46±6.97),information processing speed(40.20±8.40),attention vigilance(40.92±11.00),working memory(41.09±9.97),verbal learning,and visual learning of CHR group were significantly lower than those of healthy controls(MCCB composite score(46.26±7.64),information processing speed(45.83±8.36),attention vigilance(46.30±9.57),working memory(46.18±8.49)),and with statistically significant differences(t=-3.73--2.03,P<0.05).The total CTQ score,emotional abuse,physical abuse,and physical neglect factor scores of the CHR group(40.0(36.0,50.8),7.5(6.0,10.0),5.0(5.0,7.0),9.0(7.0,11.0))were significantly higher than those of the healthy control group(34.0(31.0,40.0),6.0(5.0,8.0),5.0(5.0,6.0),9.0(6.0,10.0))(Z=-4.07--2.06,P<0.05).In the CHR group,the total score of childhood trauma and the score of physical abuse factors were negatively correlated with working memory(r=-0.29,-0.28,P<0.05),and the total score of cognitive function,attention vigilance,and word learning were negatively correlated with physical neglect(r=-0.28,-0.26,-0.31,P<0.05).After partial correlation analysis using gender,age,years of education,and total SIPS score as covariates,the aforementioned correlation remained significant.Conclusi

关 键 词：精神病临床高危 童年创伤 认知功能 MATRICS共识认知成套测验 

分 类 号：R749[医药卫生—神经病学与精神病学]