男性精神分裂症患者自我源监测障碍与阳性症状的关系研究

摘要

Objective To investigate if male schizophrenic patients had damage of self-source monitoring, as well as whether the damage was related to delutions symptoms.Methods 20 male patients with schizophrenia (which have delutions) as study group and 20 normal subjects as control group. Patients with schizophrenia were assessed with Scale for the Assessment of Positive Symptoms (SAPS). All subjects were given source memory task and then recorded the number of correct response item, followed by Stroop color word test which was used to test the performance of selective attention. Calculated false alarms rate, missing rate, correct source score, memory score, identify index Pr, response bias index Br and the indicators of selective attention. Two samplet-test was used in comparison between patients group and control group. Using analysis of variance (ANOVA) compared to schizophrenia group and control group. Pearson related analysis was used in patient group with the indicators of selective attention, symptom score and memory score, as well as the identify index Pr of source monitoring.Results(1) The false alarms rate and miss rate in patient group were higher than control group (P<0.05), and correct source score, memory score, identify index Pr, response bias index Br and the indicators of selective attention in patient group were lower than control group, and the difference between two groups was statistically signiifcant (P<0.05).(2)The false alarms rate and miss rate in delutions group were higher than control group (P<0.05), correct source score, memory score, identify index Pr, response bias index Br and the indicators of selective attention in delutions group were lower than control group (P<0.05). (3)Pearson related analysis showed that the performance of selective attention had correlation with the performance of the source monitoring and memory score (P<0.05).Conclusion Overall male schizophrenic patients have damage in the performance of self-source monitoring and selective attention, and the damage in self-monitoring is close to delutions symptoms, suggesting the damage in self-monitoring may be the base of delutions symptoms. The performance of selective attention is associated with the damage of the source monitoring, suggesting that it may be involved in the identiifcation processing about self-source information.%目的：探讨男性精神分裂症患者是否存在自我源监测损害，以及该源监测损害是否与妄想症状有关。方法20例男性精神分裂症患者（都是以妄想症状为主）为研究组和20例正常受试者为对照组。对研究组进行阳性症状评定量表（SAPS）评分，之后给予所有受试者源记忆（SM）任务并记录正确反应的项目数，随后进行Stroop色字干扰实验来测试受试者的选择性注意功能。计算错误警报率、错过率、正确来源总分、记忆总分、辨别指数Pr、反应偏向指数Br和选择性注意指标。精神分裂症患者组与正常对照组组间比较采用双样本t检验，精神分裂症（妄想组）与正常对照组之间采用方差分析法（ANOVA）进行两两比较，对患者组的上述指标用Pearson法进行相关分析。结果（1）患者组的错误警报率、错过率均高于正常对照组（P＜0.05），而正确来源总分、记忆总分、辨别指数Pr、反应偏向指数Br和选择性注意指标均比对照组降低（P＜0.05）。（2）患者组（妄想组）的错误警报率、错过率均高于对照组（P＜0.05），正确来源总分、记忆总分、辨别指数Pr、反应偏向指数Br和选择性注意指标均低于对照组（P＜0.05）。（3）相关性分析显示患者的选择性注意指标与源监测辨别指数Pr和记忆总分有关（P＜0.05）。结论男性精神分裂症患者总体存在自我源监测和选择性注意功能的损害，且自我源监测损害与妄想症状关系密切，提示自我源监测可能是妄想的基础。选择性注意功能的损害与源监测损害相关，提示其可能参与了自我来源信息辨别的加工过程。