Flat affect in schizophrenia: Relation to emotion processing and neurocognitive measures
Flat affect in schizophrenia: Relation to emotion processing and neurocognitive measures
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DOI：
10.1093/schbul/sbj041
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发表时间：
2006-04-01
影响因子：
6.6
通讯作者：
Gur, RC
中科院分区：
文献类型：
--
作者：
Gur, RE;Kohler, CG;Gur, RC
精神分裂症患者的情绪功能受损是一个突出的临床特征，主要表现为平淡的情感。研究检查了精神分裂症患者的感知、体验和情绪表达，并报告了正常的体验评级，但情感识别受损。然而，平淡情绪与面部情绪识别和认知任务的表现之间的关系与病前适应和临床结果之间的关系还没有得到系统的研究。我们报道了一项前瞻性研究，研究对象包括63名至少有中度平淡情绪的患者和99名没有平淡情绪的患者，他们在功能领域、情绪处理任务和神经认知测量方面进行了比较。平淡的情感在男性中更常见，与较差的病前适应、较差的当前生活质量和一年随访的较差结果有关。总体而言，患者在情绪处理任务上表现得更差，这需要识别快乐和悲伤的情绪，需要区分这些情绪中的强度。对于强度区分任务，他们的反应不准确，但比对照组更快，这表明准确性和速度之间的正常关系被分解了。与其他消极症状相比，平淡的情感评分唯一地预测了情绪处理任务的表现。平淡情绪的患者在两种情绪处理任务中都表现出更大的损害，其中强度区分任务的损害最明显。然而，两组患者除了言语记忆外，在神经认知方面没有不同。我们得出结论，平淡的情感是精神分裂症的一个重要的临床特征，它加剧了病程。
Impaired emotional functioning in schizophrenia is a prominent clinical feature that manifests primarily as flat affect. Studies have examined the perception, experience, and expression of emotions in schizophrenia and reported normal ratings of experience but impaired affect identification. However, the relation between flat affect and performance on facial affect identification and cognitive tasks has not been systematically examined in relation to premorbid adjustment and clinical outcome. We report a prospective study of 63 patients with at least moderate severity of flat affect and 99 patients without flat affect, who were compared on functional domains, emotion processing tasks, and neurocognitive measures. Flat affect was more common in men and was associated with poorer premorbid adjustment, worse current quality of life, and worse outcome at 1-year follow-up. Patients overall performed more poorly on emotion processing tasks, one that required identification of happy and sad emotions and one that required differentiating among intensities within these emotions. They responded inaccurately yet faster than controls for the intensity differentiation task, suggesting a decomposition of the normal relation between accuracy and speed. Flat affect ratings, compared with other negative symptoms, uniquely predicted performance on emotion processing tasks. Patients with flat affect showed greater impairment in both emotion processing tasks, with the most pronounced impairment for the intensity differentiation task. However, the 2 patient groups did not differ in the neurocognitive profile except for verbal memory. We conclude that flat affect is an important clinical feature of schizophrenia that exacerbates the course of illness.