发精神分裂症患者认知功能与精神症状及疗效的关系

　　【摘　要】

　　目的：探讨首发精神分裂症患者的认 知功能 与精神症状及疗效的关系。方法：对164例首发精神分裂症患者随机给予氯 丙嗪或氯氮平治疗；于治疗前分别作韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、手 指敲击测试、利手测验、动作功能测验、手功能协调测验、连线测验A和B、威斯康星卡片分 类测验(WCST)及词语流畅性测验11项神经心理测查各一次，并作BPRS、SANS、功能总体评定 量表(GAF)一次；治疗12周末再评定1次上述各项检查。结果：治疗前认知 功能与阳性、阴性症状及治疗12周前后的差值无显著相关性，但治疗12周末的多数认知功能 结果与阳性、阴性症状存在显著性相关。结论：本研究支持精神分裂症的 认知功能、阳性症状、阴性症状三组症状群相互独立的假说。

　　Cognitive Function in First Episode Schizophrenics

　　Yang Fude　Michael Phillips　 Zhang Peiyan et al.

　　（Beijing Huilongguan Hospital　　100096）

　　【Abstract】Objective: To assess the relationship of cognitive f unctioning with symptomatology and treatment outcome of first episode schizophre nia. Method: First episode schizophrenic patients (n=164) were a dministered 11 neuropsychological tests prior to randomly assigned treatment w ith chlorpromazine or clozapine, Weschler Adult Intelligence Scale, Weschler Mem ory Scale, Grooved Pegboard Test, Finger Taping Test, Edinburgh Handedness Test, Trail Making Test A and B, Wisconsin Card Sort Test, a motor function test,a ha nd coordination test and a verbal fluency test. Clinical status was assessed pr i or to treatment and 12 weeks after starting treatment using the Brief Psychiatri c Rating Scale, a Chinese revision of the Scale for Assessment of Negative Sympt oms and the Global Assessment of Functioning Scale. Results: Pr e-treatment neurocognitive functioning was not re lated to the severity of positive or negative symptoms before treatment or to th e level of improvement in positive or negative symptoms with treatment, but it w as significantly related to the severity of positive and negative symptoms after 12 weeks of treatment. Conclusion: These results support the h ypothesis that ne urocognitive functioning, positive symptoms and negative symptoms are independen t symptom cluster in schizophrenia.