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国内学者发现阴性症状与认知损伤的关系在精神分裂症缺陷综合征亚型中存在差异

2022-07-11 中科院心理所 中科院心理所

缺陷综合征(deficit syndrome,DS)是精神分裂症患者中以原发性和持续性阴性症状为特征的一种亚型。前人研究显示,缺陷综合征患者相比于非缺陷综合征患者,在神经认知和社会认知方面均表现出更大

缺陷综合征(deficit syndrome,DS)是精神分裂症患者中以原发性和持续性阴性症状为特征的一种亚型。前人研究显示,缺陷综合征患者相比于非缺陷综合征患者,在神经认知和社会认知方面均表现出更大的认知缺陷,缺陷综合征亚型可作为揭示精神分裂症阴性症状和认知缺陷的关联的潜在研究对象。虽然阴性症状、神经认知能力与共情能力三者存在关联,但是目前尚无直接关于缺陷综合征患者共情能力的研究,其神经认知损伤维度的结果并不一致,因而开展了本研究。

相比于阳性症状,精神分裂症的阴性症状,包括动机、社交互动、情感体验/应答、语调韵律/言语清晰度、运动方面的缺陷对患者功能转归的消极影响可能更大,持续时间更长,且治疗应答相对欠佳。然而在时间有限的临床实践中,医生往往更加关注妄想、幻觉、瓦解症状、攻击行为等症状,而可能不太了解阴性症状的评估及治疗策略。

患者可能存在的阴性症状表现

中国科学院心理研究所心理健康重点实验室张向阳研究组招募了665例慢性精神分裂症患者。研究通过缺陷综合征的代理量表(The Proxy Scale for Deficit Syndrome,PDS)进行分组,150名缺陷组患者和140名非缺陷组患者纳入分析。患者的神经认知和共情能力分别用重复性成套神经心理状态测验和人际反应指数量表测量。此外,该研究收集了患者人口学信息,并通过阳性和阴性症状量表评估了患者临床症状的严重程度。

结果显示,缺陷组患者在除视觉空间维度以外的所有神经认知维度和共情能力维度上均表现得比非缺陷组差。回归结果显示,一般精神病理症状和教育程度与缺陷组的神经认知总分相关;而在非缺陷组患者中,教育程度和阴性症状与神经认知总分相关。同时,在非缺陷组中,自杀和阴性症状因子评分被发现与共情能力总分独立相关;而在缺陷组中,没有变量与共情能力总分相关。

综上,缺陷组患者的神经认知和共情能力相比于非缺陷组的患者更差。在慢性精神分裂症患者中,阴性症状可能在缺陷组和非缺陷组的认知中发挥不同作用。

相关研究成果在线发表在Progress in Neuropsychopharmacology & Biological Psychiatry上。研究工作得到中科院国际合作研究计划与中科院心理健康重点实验室的支持。

原始出处:

Liu, J., Tian, Y., Wei, S., Wang, W., Wang, D., Zhou, H., & Zhang, X. (2022). Association of empathy with clinical symptoms and cognitive function in Chinese chronic schizophrenia patients with and without deficit syndrome. Progress in neuro-psychopharmacology & biological psychiatry, 110592. Advance online publication. https://doi.org/10.1016/j.pnpbp.2022.110592

Dawn I. Velligan, Larry D. Alphs. Negative Symptoms in Schizophrenia: An Update on Identification and Treatment. Psychiatric Times

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    2022-08-20 ms2000000251512384

    学到了学到了

    0

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    2022-07-11 wamgel2

    学习了!

    0

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    2022-07-11 147673c8m19暂无昵称

    已读

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