CAJ | 학술논문

目的探讨缓解期分裂症和缓解期双相情感障碍(BPD)认知功能损害模式和心理社会功能的差别.方法采用8个神经心理测验(共17项)对缓解期分裂症32例、缓解期BPD30例和正常对照组34例进行注意力、言语学习和记忆、视觉记忆和执行功能的评定,用多变量方差分析的方法比较各组认知功能的差异.结果缓解期分裂症组除StroopC和数字广度测验-顺背外,其余15个神经心理学指标均差于对照组(P＜0.05或P＜0.01),缓解期BPD只有9个指标差于对照组,缓解期分裂症组的即刻逻辑记忆、延迟逻辑记忆、StroopCW得分比缓解期BPD差[分别为(8.13±3.35)分,(12.11±3.72)分,(6.00±3.09)分,(9.78±3.60)分；(48.61±15.73)分,(69.33±21.04)分,P＜0.05],比缓解期BPD损害严重,但是在WCST的完成分类数、持续性错误数、非持续性错误数、完成第一分类所需应答数、数字广度测验-倒背和TMT-B上两组的操作结果无显著性的差别,损害同样严重,缓解期BPD的心理社会功能和缓解期分裂症的心理社会功能有显著性差异(P＜0.01).结论缓解期BPD的认知损害领域和缓解期分裂症存在一些重叠,而缓解期分裂症的损害更为广泛和严重；缓解期BPD的心理社会功能好于缓解期分裂症.
목적 탐토완해기분렬증화완해기쌍상정감장애(BPD)인지공능손해모식화심리사회공능적차별.방법 채용8개신경심리측험(공17항)대완해기분렬증32례、완해기BPD30례화정상대조조34례진행주의력、언어학습화기억、시각기억화집행공능적평정,용다변량방차분석적방법비교각조인지공능적차이.결과 완해기분렬증조제StroopC화수자엄도측험-순배외,기여15개신경심이학지표균차우대조조(P＜0.05혹P＜0.01),완해기BPD지유9개지표차우대조조,완해기분렬증조적즉각라집기억、연지라집기억、StroopCW득분비완해기BPD차[분별위(8.13±3.35)분,(12.11±3.72)분,(6.00±3.09)분,(9.78±3.60)분；(48.61±15.73)분,(69.33±21.04)분,P＜0.05],비완해기BPD손해엄중,단시재WCST적완성분류수、지속성착오수、비지속성착오수、완성제일분류소수응답수、수자엄도측험-도배화TMT-B상량조적조작결과무현저성적차별,손해동양엄중,완해기BPD적심리사회공능화완해기분렬증적심리사회공능유현저성차이(P＜0.01).결론 완해기BPD적인지손해영역화완해기분렬증존재일사중첩,이완해기분렬증적손해경위엄범화엄중；완해기BPD적심리사회공능호우완해기분렬증.
Objective To explore the difference of cognitive function and psychosocial function between remitted bipolar disorder(BPD) and remitted schizophrenia.Methods 8 neuropsychological tests (17 items)which evaluate attention,verbal learning and memory,visual memery and executive function were given to 30 remitted BPD,32 remitted schizophrenia and 34 normal controls.The differences of cognitive functions between the three groups were compared using multivariate analysis of variance (MANOVA).Psychosocial functions of remitted BPD and remitted schizophrenia were both evaluated by Global Assessment Function (GAF),and the difference of Psychosocial functions between the two groups was also tested by MANOVA.Results 1.Remitted schizophrenia showed dysfunction in neuropsychological tests except Stroop C and digit span subtest-forward compared with controis.but Remitted BPD only showed dysfunction in 9 neuropsychological items compared with controls.There was no significantly differences on WCST,digit span subtest-backward,and TMT-B between remitted BPD and remitted schizophrenia,the degree of impairment of the two groups was same.But scores from logical memory sub-test and Stroop CW of remitted schizophrenia were significantly lower than that of remitted BPD( ( 8.13 ± 3.35),( 12.11 ±3.72),(6.00 ±3.09),(9.78 ±3.60);(48.61±15.73),(69.33 ±21.04),P＜0.05).There was significant difference on scores of GAF between remitted BPD and remitted schizophrenia.Conclusion There are some overlap in cognitive impairment in remitted BPD and remitted schizophrenia,but in remitted schizophrenia the cognitive profile is characterized by generalized and severer pattern of deficits.The psychosocial function of remitted BPD is better than that of remitted schizophrenia.