急性期治疗对精神分裂症认知功能的影响及与症状变化的相关性

为了探讨精神分裂症患者急性期治疗后认知功能的变化以及与精神症状变化之间的关系。通过收集精神分裂症患者37例,给予利培酮治疗3个月,应用阳性和阴性症状量表(positive and nequtive syndrome scale,PANSS)及精神分裂症认知功能成套测验共识版(MATRICS consesuscognitive battery,MCCB)分别评估患者治疗前后的临床症状及认知功能的方法研究了精神分裂症患者急性期治疗后认知功能的变化以及与精神症状变化之间的关系。结果表明治疗后患者的处理速度(P 0. 01)、工作记忆(P 0. 01)及推理与解决问题能力(P 0. 01)均较治疗前显著性升高,言语学习和记忆、视觉学习和记忆及社会认知功能较治疗前无明显变化;治疗后患者PANSS总分(P 0. 01)、阳性症状评分(P 0. 01)、阴性症状评分(P 0. 01)及一般病理症状评分(P 0. 01)均较治疗前显著降低;治疗后认知功能中处理速度(r=0. 55,P 0. 01)及工作记忆(r=0. 42,P 0. 05)的改善与阴性症状的缓解正相关,与总症状、阳性症状及一般病理症状的改善无相关性,推理与解决问题能力的改善与总症状、阳性症状、阴性症状及一般病理症状的改善均无相关性。可见急性期药物治疗可改善精神分裂症患者认知功能中的处理速度、工作记忆及推理与解决问题能力,处理速度及工作记忆的改善与阴性症状的缓解相关。

The Effect of Acute Treatment on Cognitive Function of Schizophrenia and Its Correlation with Symptoms Changes

In order to explore the effect of acute drug on cognitive function and the correlation with psychiatric symptoms of patients with schizophrenia. The PANSS was used to assess clinical symptoms and the MCCB was used to assess the cognitive function. All patients were treated with risperidone, MCCB and PANSS assessment were conducted after three months of follow-up, To analyze the changes of cognitive function and the relationship between cognitive function and psychiatric symptoms in patients with schizophrenia. The results show that the processing speed (P < 0.01), working memory (P < 0.01) and reasoning and problem-solving abilities (P < 0.01) of the patients were significantly higher than those before treatment, There were no significant changes in speech learning and memory, visual learning and memory and social cognitive functions after treatment; The total score of PANSS (P< 0.01), positive symptom score (P<0.01), negative symptom score (P<0.01) and general psychopathological symptoms score (P<0.01) of patients with schizophrenia were significantly lower than those before treatment; The improvement of processing speed (r = 0.55, P < 0.01) and working memory (r = 0.42, P < 0.05) was significantly positively correlated with the improvement of negative symptoms, but not with the improvement of total symptoms, positive symptoms and general psychopathological symptoms. There was no correlation between the improvement of reasoning and problem solving ability and psychiatric symptoms. It is concluded that acute drug therapy can improve the processing speed, working memory, reasoning and problem-solving ability of patients with schizophrenia, the improvement of processing speed and working memory is related to the alleviation of negative symptoms.