摘要
目的探讨利培酮治疗对未服药首发精神分裂症患者认知功能的影响,以及认知功能与症状变化的关联。方法采用威斯康星卡片分类测验、数字广度测试、词语流畅性测试、Stroop测试、连线测试评估42例首发未服药精神分裂症患者的执行功能、工作记忆、信息处理速度等变化;阳性和阴性症状量表评定患者精神症状;多元回归分析探讨认知功能与精神症状的关联。结果治疗前,患者组威斯康星测验持续错误数较对照组多(P<0.001),完成分类数较对照组少(P=0.009);数字广度测试及词语流畅性分数(Ps<0.001)均降低;Stroop及连线测试完成时间均较对照组延长(Ps<0.001)。治疗后,患者组Stroop_B(P=0.022)、Stroop_C(P=0.033)完成时间较治疗前减少。治疗前连线测试A/B成绩越差,则阴性症状及总症状(Ps<0.05)越严重;连线测试A成绩越差,阳性症状的改善越少(P=0.019)。结论精神分裂症患者发病早期存在认知功能损害;急性期治疗可改善精神病性症状及信息处理速度,但不改善执行功能及工作记忆;提示患者早期信息处理受损可能更接近状态性生物学标记,而执行功能、工作记忆受损更接近素质性生物学标记。
Objective To explore cognitive function changes after risperidone monotherapy and their relationship to psychotic symptoms in treatment-na？ve first-episode schizophrenia patients. Methods We collected 42 treatmentna？ve patients with first-episode schizophrenia,and used Wisconsin Card Sorting Test（WCST）,Digit Span Distraction Test（DSDT）,Verbal Fluency Test（VFT）,Stroop Color Word Test and Trail Marking Test（TMT）to explore their executive function,working memory and information processing speed. Positive and Negative Syndrome Scale（PANSS）was used to evaluate patients＇ symptoms at baseline and after treatment. Multiple regression analysis was utilized to compute the relation between cognitive deficits and symptoms. Results At baseline,WCST_perseverative errors of patients were significantly more than controls（P〈0.001）;the number of WCST_categories,DSDT_forward/backward and VFT was significantly less than controls（Ps0.01）. The time consumed in Stroop and TMT of patients was significantly more than that of controls（Ps0.001）. After treatment,patients＇ time consumed in Stroop_B and Stroop_C was significantly less than that at baseline,but there were no significant within-group differences in other cognitive performance. The worse of the performance in TMT_A/B,the more severe of patients＇ negative and total symptoms（Ps0.05）. The worse performance of the TMT_A at baseline,the less improvement of patients＇ positive symptoms（P=0.019）. Conclusions Patients already have suffered from extensive cognitive impairments in their early episode. Patients＇ psychotic symptoms and information processing deficits can be improved after therapy,although their executive function and working memory are not improved. These imply that information processing deficits in patients may be state-biomarkers,but executive function and working memory impairments may be trait-biomarkers.
作者
胡茂林
宗小芬
唐劲松
廖艳辉
李宗昌
贺莹
陈晓岗
HU Maolin;ZONG Xiaofen;TANG Jinsong(Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《国际精神病学杂志》
2018年第4期587-590,共4页
Journal Of International Psychiatry
基金
国家自然基金(编号:81271484
81471361)
武汉市科技应用基础研究(编号:2017060201010169)
关键词
精神分裂症
利培酮
认知功能
Schizophrenia
Risperidone
Cognitive function
