Neurological signs and the heterogeneity of schizophrenia
Neurological signs and the heterogeneity of schizophrenia
复制标题
DOI：
10.1176/appi.ajp.157.4.560
复制
发表时间：
2000-04-01
影响因子：
17.7
通讯作者：
Buchanan, RW
中科院分区：
文献类型：
--
作者：
Arango, C;Kirkpatrick, B;Buchanan, RW
目的：20多项精神分裂症研究发现了一个由幻觉/妄想、思维和行为紊乱以及阴性症状组成的症状复合体或综合征的三因素模型。几条证据表明，这些综合征与神经生物学差异有关。我们研究了这三种综合征与神经系统体征的关系。方法：在83例临床稳定的门诊精神分裂症患者中，检查了神经功能评估量表各分量表与幻觉/妄想、混乱和缺陷综合征之间的关系。缺陷综合征患者具有持久的、特发性（或原发性）阴性症状。结果：这三种证候与神经系统体征的关系各有特点。紊乱与神经功能评价量表总分、感觉统合和复杂运动行为的顺序显著相关。缺陷综合征仅与感觉统合显著相关。无论是幻觉/妄想还是来自简明精神病评定量表（测量原发性和继发性阴性症状以及持久性和短暂性症状）的阴性症状的连续测量，都与任何神经学评价量表子量表或总分无关。药物治疗与神经功能损害无关。结论：本研究结果进一步支持了精神分裂症三种临床症状的神经生物学意义。评定量表测量阴性症状似乎是不太敏感的神经生物学相关性比是存在或不存在的缺陷综合征的分类。
Objective: More than 20 studies of schizophrenia have found a three-factor model of symptom complexes or syndromes consisting of hallucinations/delusions, disorganization of thought and behavior, and negative symptoms. Several lines of evidence suggest that these syndromes relate to neurobiological differences. We examined the relationship of these three syndromes to neurological signs. Method: The relationships among the subscales of the Neurological Evaluation Scale and hallucinations/delusions, disorganization, and the deficit syndrome were examined in 83 clinically stable outpatients with schizophrenia. Patients with the deficit syndrome have enduring, idiopathic (or primary) negative symptoms. Results: Each of the three syndromes had a distinctive pattern of relationships to neurological signs. Disorganization was significantly related to the total score on the Neurological Evaluation Scale, to sensory integration, and to the sequencing of complex motor acts. The deficit syndrome was significantly related to sensory integration only. Neither hallucinations/delusions nor a continuous measure of negative symptoms derived from the Brief Psychiatric Rating Scale (that measured both primary and secondary negative symptoms, as well as enduring and transient symptoms) was related to any of the Neurological Evaluation Scale subscales or total score. Drug treatment was not related to neurological impairment. Conclusions: The results further support the neurobiological significance of the three clinical syndromes of schizophrenia. Ratings on a scale measuring negative symptoms appear to be less sensitive to neurobiological correlates than is the categorization of the presence or absence of the deficit syndrome.