缺陷型和非缺陷型精神分裂症患者早期认知视觉图形记忆功能

摘要

目的 探讨首发精神分裂症缺陷型与非缺陷型患者视觉图形记忆的差异.方法 纳入199例首发未治疗精神分裂症患者及148名正常对照.采用缺陷型精神分裂症诊断量表中文版(Schedule for the Deficit Syndrome,SDS)将患者分为缺陷型(51例)和非缺陷型(148例)两组.使用视觉图形记忆(Pattern Recognition Memory,PRM)工具评定患者和对照的即刻与延迟时相图形记忆功能.用阳性与阴性症状量表(Positive and Negative Symptom Scale,PANSS)评定两组患者的症状严重程度.结果 与对照组比较,两患者组(除非缺陷型即刻时相反应时长外)所有图形记忆功能均较差(P＜0.05).两组患者间比较,即刻时相图形记忆功能差异无统计学意义[(3751.00±2552.89)vs.(2999.80±1834.20),P=0.22；(86.49±15.34)vs.(87.28±16.00),P=0.96],而延迟时相缺陷型较非缺陷型反应时长更长[(5086.80±7528.54)vs.(3527.40±3649.08),P＜0.01],正确率更低[(63.10±19.17)vs.(70.69±15.34),P＜0.01].图形记忆指标与缺陷型患者的阴性症状无相关性(P＞0.05).结论 精神分裂症在疾病早期认知功能视觉图形记忆即受到损害.首发缺陷型精神分裂症图形记忆功能只有在延迟时相才与非缺陷型表现出差异,记忆反应时长在即刻与延迟时相始终延长.提示这是一类具有特征性的认知功能缺损特点的精神分裂症亚型.%Objective To investigate the difference of Pattern Recognition Memory among first-episode treatment-naive patients with deficit and nondeficit schizophrenia. Methods 199 first-episode treatment-naive patients with schizophrenia, and 148 controls were recruited. Schedule for the Deficit Syndrome (SDS) was used to categorize the patients into deficit or nondeficit subtype. Pattern Recognition Memory (PRM) was used to test the immediate and delayed mode of visual pattern memory. Positive and Negative Symptom Scale (PANSS) was used to assess the degree of patients symptoms. Results Compared with controls, the PRM indices were significant poorer (P<0.05) in two subtypes of patients (except time lantency in immediate mode of nondeficit patients). There was no significant difference in the performance of immediate mode of PRM between deficit and nondeficit patients [(3751.00±2552.89) vs. (2999.80 ± 1834.20), P=0.22; (86.49 ±15.34) vs. (87.28 ±16.00), P=0.96]. But in delayed mode, the time latency was longer [(5086.80 ±7528.54) vs.rn(3527.40±3649.08), P<0.01] and the percent correct was lower [(63.10± 19.17) vs. (70.69±15.34), P<0.01] in patients with deficit schizophrenia. And PRM had no significant correlation with the negative symptoms of deficit schizophrenia (P>0.05). Conclusion The PRM is impared at the early stage of schizophrenia. The PRM difference between first-episode treatment-naive deficit schizophrenia and nondeficit schizophrenia was only in delayed mode, and the deficit schizophrenia take longer time in both memory modes. The deficit schizophrenia is a subtype of schizophrenia with unique impairment of cognitive functions.