CAJ | 학술논문

目的：探讨首发未用药精神分裂症患者认知功能、生活技能状况及其与临床特征的关系。方法纳入首发精神分裂症住院患者145例和65名正常对照，采用精神分裂症认知功能成套测验中文版（MATRICS consensus cognitive battery，MCCB）、Stroop色词测验等评估两组认知功能，加州大学圣地亚哥分校基于任务的生活技能测验（University of California, San Diego performance-based skill assessment，UPSA）评估生活技能，阳性和阴性症状量表（positive and negative syndrome scale，PANSS）评估患者精神症状。结果患者组的MCCB总分、10项分测验、数字广度测验、情绪识别测验、Stroop色词测验得分均低于对照（均P<0.05）；患者组的UPSA财务技能分、交流技能分及UPSA总分均低于对照组（均P<0.05）。偏执型精神分裂症患者的语言记忆、视觉记忆评分、Stroop色词测验、UPSA交流技能分、UPSA总分高于非偏执型患者（均P<0.05）。Logistic回归分析显示MCCB的影响因素为受教育年限（OR=1.29，95%CI：1.13~1.47）及PANSS总分（OR=0.95，95%CI：0.92~0.97）。结论首发未用药精神分裂症认知功能、生活技能明显受损，损害程度与精神病理症状有关联，偏执型患者的认知功能、生活技能好于非偏执型患者。
목적：탐토수발미용약정신분렬증환자인지공능、생활기능상황급기여림상특정적관계。방법납입수발정신분렬증주원환자145례화65명정상대조，채용정신분렬증인지공능성투측험중문판（MATRICS consensus cognitive battery，MCCB）、Stroop색사측험등평고량조인지공능，가주대학골지아가분교기우임무적생활기능측험（University of California, San Diego performance-based skill assessment，UPSA）평고생활기능，양성화음성증상량표（positive and negative syndrome scale，PANSS）평고환자정신증상。결과환자조적MCCB총분、10항분측험、수자엄도측험、정서식별측험、Stroop색사측험득분균저우대조（균P<0.05）；환자조적UPSA재무기능분、교류기능분급UPSA총분균저우대조조（균P<0.05）。편집형정신분렬증환자적어언기억、시각기억평분、Stroop색사측험、UPSA교류기능분、UPSA총분고우비편집형환자（균P<0.05）。Logistic회귀분석현시MCCB적영향인소위수교육년한（OR=1.29，95%CI：1.13~1.47）급PANSS총분（OR=0.95，95%CI：0.92~0.97）。결론수발미용약정신분렬증인지공능、생활기능명현수손，손해정도여정신병리증상유관련，편집형환자적인지공능、생활기능호우비편집형환자。
Objective To evaluate cognitive impairment and performance-based skills and to explore their rela?tionships with clinical phenotypes in drug-na?ve first-episode patients with schizophrenia. Methods One hundred and forty-five inpatients and 65 healthy controls matched for age, gender and education were recruited. The MATRICS Con?sensus Cognitive Battery (MCCB), Stroop, digit span test, emotional recognition test, University of California, San Diego, Performance-based Skill Assessment (UPSA) and Positive Negative Syndrome Scale scale (PANSS) were used to evaluate cognitive function, life skill and symptoms, respectively. Results Compared with the controls, total score of MCCB and scores of 10 subscales, scores of digit span, emotional recognition and Stroop were significantly lower in patients (all P<0.05). The UPSA total score and scores of financial skill and communication skill were lower in patients than in controls (all P<0.05). Verbal memory, visual memory , Stroop, communication skill scores and total UPSA standard score were sig?nificantly higher in patients with paranoid subtype of schizophrenia than in patients with non-paranoid subtype of schizo? phrenia (all P<0.05). The score of MCCB associated with education years (OR=1.29, 95%CI: 1.13~1.47) and PANSS (OR=0.95, 95%CI:0.92~0.97). Conclusions First-episode, drug-naive patients with schizophrenia have markedly cog?nitive and performance-based skills deficits, which are associated with clinical symptoms. These deficits are differences between paranoid subtype and non-paranoid subtype of schizophrenia.