CAJ | 학술논문

　　目的：研究精神分裂症患者在完成不同难度等级的伦敦塔（TOL）任务中的执行功能，并确认TOL作为精神分裂症认知功能测量工具的适当性。方法：精神分裂症患者27例（患者组），健康对照者28例（对照组），分别进行电子化TOL测试，记录分析2组解题时间和答题正确率。结果：患者组在中等难度等级的测验中，答题时间与对照组无差异，但在其他难度等级的任务中，答题时间均明显高于对照组（P<0.05）；在所有等级的任务难度中，患者组的答题正确率显著低于对照组（P<0.01），且患者组在低难度等级的任务中的答题时间低于难度等级较高的任务（P<0.001），答题正确率下降(P<0.001)；另外，TOL的解题时间与认知症状呈显著正相关（r=0.499，P<0.05），在中、高难度中则与兴奋症状呈负相关（r=-0.452， P<0.05；r=-0.553，P<0.05）；答题正确率在中、高难度与认知症状呈显著负相关（r=-0.438，P<0.01；r=-0.672，P<0.01)。结论：TOL宜作为精神分裂症认知功能测量工具，而精神分裂症患者的认知功能可能在TOL测验中的反应时间与正确率上受到冲动与认知相关症状的影响而出现异常。
　　목적：연구정신분렬증환자재완성불동난도등급적륜돈탑（TOL）임무중적집행공능，병학인TOL작위정신분렬증인지공능측량공구적괄당성。방법：정신분렬증환자27례（환자조），건강대조자28례（대조조），분별진행전자화TOL측시，기록분석2조해제시간화답제정학솔。결과：환자조재중등난도등급적측험중，답제시간여대조조무차이，단재기타난도등급적임무중，답제시간균명현고우대조조（P<0.05）；재소유등급적임무난도중，환자조적답제정학솔현저저우대조조（P<0.01），차환자조재저난도등급적임무중적답제시간저우난도등급교고적임무（P<0.001），답제정학솔하강(P<0.001)；령외，TOL적해제시간여인지증상정현저정상관（r=0.499，P<0.05），재중、고난도중칙여흥강증상정부상관（r=-0.452， P<0.05；r=-0.553，P<0.05）；답제정학솔재중、고난도여인지증상정현저부상관（r=-0.438，P<0.01；r=-0.672，P<0.01)。결론：TOL의작위정신분렬증인지공능측량공구，이정신분렬증환자적인지공능가능재TOL측험중적반응시간여정학솔상수도충동여인지상관증상적영향이출현이상。
Objective:To study the executive function of schizophrenia patients in completing different diffi-culty level of Tower of London (TOL), and to confirm the suitability of TOL as a cognitive assessment tool for schizophrenia patients. Methods:Twenty-seven schizophrenia patients (patients group) and 28 healthy volun-teer (control group) were given computerized TOL assessment. The response time and correct rate would be collected and analyzed. Results:On medium difficulty questions, patients and control groups didn’t have a dif-ference in time required for solving TOL items. However, time required on solving problems were significantly higher in easy and difficult questions (P<0.05), and the accuracy was significantly lower than the control group in all difficulties (P<0.01). In addition, a within group comparison showed significant lengthening of time and lowering of accuracy when comparing between easy and difficult levels (P<0.001). Moreover, the problem solving time of TOL was positively correlated to cognitive symptoms in easy level (r=0.499, P<0.05), while in higher difficulties, problem solving time was negatively correlated to excitability-Hostility symptoms (r=-0.452, P<0.05;r=-0.553, P<0.05);also, the correct response rate is negatively correlated to cognitive symp-toms in higher difficulties (r=-0.438, P<0.01;r=-0.672, P<0.01). Conclusion:TOL may be a suitable tool for cognitive ability assessment, while the cognitive function may be affected by impulse and cognitive related symptoms.