高功能和低功能早发性精神分裂症患者的社会知觉和心理推理能力损伤的特点

摘要

目的:探索高/低功能早发性精神分裂症患者的社会认知损伤特点.方法:选取符合疾病和有关健康问题的国际统计分类第十次修订本(ICD-10)诊断标准的13 ～18岁的早发性精神分裂症患者84例,经测定社交能力,习得能力、身体体质合成分总分＞7分为高功能早发性精神分裂症组(n=41),总分＜4分为低功能早发性精神分裂症组(n=43),并选取年龄、性别、受教育程度匹配的正常对照组45例.采用眼区基本情绪识别、儿童版复杂眼区情绪识别、小明心理推理能力的任务和失言识别任务评估三组被试的社会知觉和心理推理能力.结果:低功能早发精神分裂症患者组在儿童版复杂情绪识别任务的得分低于对照组[(17±4)vs.(9±3),P＜0.05];低功能早发精神分裂症患者在二级认知心理推理能力[(71±18) vs.(83±13),P＜0.01]、失言情景识别得分[(8±2)vs.(9±2),P＜0.05]低于正常对照组;高功能和低功能早发性精神分裂症患者在二级情感心理推理能力[(80±14),(75±15) vs.(87±10),P＜ 0.01]和理解失言情景的得分[(17±6),(14±5) vs.(21±6),P＜0.01]明显低于对照组.结论:高功能早发精神分裂症患者心理推理能力存在损伤,社会知觉能力未受损;低功能早发精神分裂症患者社会知觉和心理推理能力均受损.%Objective:To explore the characteristics of the social cognition in patients with high/low functioning early onset schizophrenia (HF-EOS).Methods:Eighty-four 13-18 years old patients with early onset schizophrenia and 45 gender-,age-,and level of education-matched healthy controls (HC) were selected.The diagnosis was made according to the criteria of the International Statistical Classification of Diseases and Related Health Prob lem,Tenth Revision (ICD-10) for schizophrenia.All patients were divided into HF-EOS group (total score ＞ 7,n =41) and LF-EOS group (total score ＜ 4,n =43)in the three aspects total score of social attainment,social compe tence and functional capacity.All patients were assessed with the Eye Basic Emotion Discrimination Task,Reading the Mind in the eyes,Yoni task and Faux Pas Recognition task.Results:Compared with healthy controls,LF-EOS patients performed poorer on Reading the Mind in the eyes task [(17 ± 4) vs.(9 ± 3.0),P ＜ 0.05],second-order cognitive condition of the Yoni task [(71 ± 18) vs.(83 ± 13),P ＜ 0.01] and Recognizing Faux pas [(8 ± 2) vs.(9 ± 2),P ＜0.05].HF-EOS and LF-EOS patients performed worse than the controls on second-order affective condition of the Yoni task [(80 ± 14),(75 ± 15) vs.(86.5 ± 10.0),P ＜ 0.01] and understanding paux pas [(17 ± 5),(14 ± 5) vs.(21 ± 6),P ＜ 0.01].Conclusion:It suggests that HF-EOS have preserved social perceptual abilities compared to LF-EOS patients.HF-EOS patients and LF-EOS patients both have impaired theory of mind compared to controls.