Neurocognitive Impairments in Deficit and Non-Deficit Schizophrenia and Their Relationships with Symptom Dimensions and Other Clinical Variables.
Neurocognitive Impairments in Deficit and Non-Deficit Schizophrenia and Their Relationships with Symptom Dimensions and Other Clinical Variables.
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缺乏性和非缺乏性精神分裂症的神经认知障碍及其与症状维度和其他临床变量的关系
DOI：
10.1371/journal.pone.0138357
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Zhang Z
中科院分区：
文献类型：
--
作者：
Yu M;Tang X;Wang X;Zhang X;Zhang X;Sha W;Yao S;Shu N;Zhang X;Zhang Z
缺乏性精神分裂症（DS）被认为是精神分裂症中一个病理生理上独特的亚群。早期关于退行性精神分裂症患者神经认知功能的研究得出了不一致的结果，从严重缺陷到与非缺陷精神分裂症患者（NDS）没有显著差异。本研究探讨了退行性痴呆和非退行性痴呆患者神经认知障碍的严重程度、特征模式及其与临床变量的关系。方法采用综合神经心理学方法对40例退行性痴呆患者、57例非退行性痴呆患者和52例正常人的注意力、思维流畅性、认知灵活性和视觉空间记忆功能进行评估。结果两组精神分裂症患者的认知障碍均较对照组严重，除Stroop干扰外，DS在各神经心理学指标上均低于以年龄和受教育程度为协变量的NDS患者。特征分析发现，两组患者的认知特征模式存在显著差异，这主要是由于两组患者的注意力和认知灵活性功能存在差异。在NDS组中，年龄、受教育程度、病程、阴性症状与认知功能障碍相关，而在DS组中，只有年龄和阴性症状与认知功能障碍相关。多元回归分析显示，持续注意和认知灵活性分别是退行性痴呆和非退行性痴呆患者的核心认知功能受损域。结论退行性痴呆患者在几乎所有认知领域的表现都比非退行性痴呆患者差。持续注意力和认知灵活性可能分别是退行性痴呆和非退行性痴呆患者认知功能受损的关键领域。目前的研究表明，DS是精神分裂症的一个特殊亚群。
Background Deficit schizophrenia (DS) has been proposed as a pathophysiologically distinct subgroup within schizophrenia. Earlier studies focusing on neurocognitive function of DS patients have yielded inconsistent findings ranging from substantial deficits to no significant difference relative to non-deficit schizophrenia patients (NDS). The present study investigated the severity and characteristic patterns of neurocognitive impairments in DS and NDS patients and their relationships with clinical variables. Methods Attention, ideation fluency, cognitive flexibility and visuospatial memory function were assessed in 40 DS patients, 57 NDS patients, and 52 healthy controls by a comprehensive neuropsychological battery. Results Both schizophrenia subgroups had overall more severe cognitive impairments than controls while DS performed worse on every neuropsychological measure except the Stroop interference than the NDS patients with age and education as the covariates. Profile analysis found significantly different patterns of cognitive profiles between two patients group mainly due to their differences in attention and cognitive flexibility functions. Age, education, illness duration and negative symptoms were found to have the correlations with cognitive impairments in the NDS group, while only age and the negative symptoms were correlated with the cognitive impairments in the DS group. Multiple regression analyses revealed that sustained attention and cognitive flexibility were the core impaired cognitive domains mediating other cognitive functions in DS and NDS patients respectively. Conclusions DS patients exemplified worse in almost all cognitive domains than NDS patients. Sustained attention and cognitive flexibility might be the key impaired cognitive domains for DS and NDS patients respectively. The present study suggested the DS as a specific subgroup of schizophrenia.