CAJ | 학술논문

目的探讨精神分裂症患者元认知能力损害与心理推测能力缺陷之间的关系.方法采用修订版元认知评估量表(Abbreviated Metacognition Assessment Scale,MAS-A)评估70例稳定期精神分裂症患者(分裂症组)和50例焦虑障碍患者(焦虑障碍组)的元认知能力,同时采用心理理论故事图片任务(Theory of Mind-Picture Sequencing Task,ToM-PST)对两组患者和55名健康人(对照组)作评估,比较精神分裂症患者与焦虑性障碍患者元认知能力,分析精神分裂症患者元认知能力与心理推测能力的相关性.结果分裂症组MAS-A总分[(8.91±3.45)分]及其自我反省[(3.46±1.11)分]、理解他人[(2.50±1.09)分]、去中心化[(0.46±0.57)分]和控制[(2.49±1.19)分]分量表分均低于焦虑障碍组[分别为:(12.72±3.27)、(4.79±1.16)、(3.28±0.95)、(1.09±0.70)、(3.56±1.08)分],差异具有统计学意义(Z=-3.858 ～-5.309,均P＜0.01).分裂症组[(47.30±9.19)分]与焦虑障碍组[(55.58±5.02)分]ToM-PST总分显著低于对照组[(58.29 ±1.06)分],差异具有统计学意义(Z=-8.344,-2.084,均P＜0.05).Spearman相关分析显示,分裂症组MAS-A总分与ToM-PST总分呈正相关(r=0.460,P＜0.01),与PANSS总分(r=-0.547,P＜0.01)、阴性症状分(r=-0.518,P＜0.01)和阳性症状分(r=-0.348,P＜0.01)均呈负相关.控制PANSS总分和病程后,分裂症组MAS-A总分与ToM-PST总分间仍具有相关性(r=0.418,P＜0.01).结论精神分裂症患者元认知能力和心理推测能力均受损,两者间存在关联,提示元认知与心理推测能力可能具有共同的神经生理基础.
목적 탐토정신분렬증환자원인지능력손해여심리추측능력결함지간적관계.방법 채용수정판원인지평고량표(Abbreviated Metacognition Assessment Scale,MAS-A)평고70례은정기정신분렬증환자(분렬증조)화50례초필장애환자(초필장애조)적원인지능력,동시채용심리이론고사도편임무(Theory of Mind-Picture Sequencing Task,ToM-PST)대량조환자화55명건강인(대조조)작평고,비교정신분렬증환자여초필성장애환자원인지능력,분석정신분렬증환자원인지능력여심리추측능력적상관성.결과 분렬증조MAS-A총분[(8.91±3.45)분]급기자아반성[(3.46±1.11)분]、리해타인[(2.50±1.09)분]、거중심화[(0.46±0.57)분]화공제[(2.49±1.19)분]분량표분균저우초필장애조[분별위:(12.72±3.27)、(4.79±1.16)、(3.28±0.95)、(1.09±0.70)、(3.56±1.08)분],차이구유통계학의의(Z=-3.858 ～-5.309,균P＜0.01).분렬증조[(47.30±9.19)분]여초필장애조[(55.58±5.02)분]ToM-PST총분현저저우대조조[(58.29 ±1.06)분],차이구유통계학의의(Z=-8.344,-2.084,균P＜0.05).Spearman상관분석현시,분렬증조MAS-A총분여ToM-PST총분정정상관(r=0.460,P＜0.01),여PANSS총분(r=-0.547,P＜0.01)、음성증상분(r=-0.518,P＜0.01)화양성증상분(r=-0.348,P＜0.01)균정부상관.공제PANSS총분화병정후,분렬증조MAS-A총분여ToM-PST총분간잉구유상관성(r=0.418,P＜0.01).결론 정신분렬증환자원인지능력화심리추측능력균수손,량자간존재관련,제시원인지여심리추측능력가능구유공동적신경생리기출.
Objective To explore the metacognitive ability of patients with schizophrenia and its relationship with theory of mind.Methods Seventy schizophrenic patients in post-acute phase of illness and 50 patients with anxiety disorder were assessed with the Abbreviated Metacognition Assessment Scale (MAS-A) in order to measured their ability of metacognition,then the two groups of patients and 55 normal people were assessed with Theory of Mind-Picture Sequencing Task (ToM-PST).The metacognitve function of patients with schizophrenia was compared with that of patients with anxiety disorder.Correlation between metacognition ability and theory of mind in patients with schizophrenia was analyed using Spearman correlation anlysis.Results The MAS-A total score,the subscores of self-reflectivity,understanding the others' mind,decentration and mastery (respectively 8.91 ± 3.45,3.46 ± 1.11,2.50 ± 1.09,0.46 ± 0.57,2.49 ± 1.19) were significantly lower in the patients with schizophrenia than those in the patients with anxiety disorder (respectively 12.72 ± 3.27,4.79 ±1.16,3.28 ±0.95,1.09 ±0.70,3.56 ± 1.08;Z=-3.858--5.309,all P ＜0.01).Compared with the normal people,patients with schizophrenia and anxiety disorder had significantly lower total scores in ToM-PST (47.30 ± 9.19 vs.58.29 ±1.06;55.58 ±5.02 vs.58.29 ±1.06;Z=-8.344,-2.084;both P ＜0.05).Correlation analysis showed a positive correlation between the total score of MAS-A and that of ToM-PST (r =0.460,P ＜0.01) in the patients with schizophrenia,and the correlation was persisted when the PANSS total score and ill-ness duration were statistically controled (r =0.418,P ＜ 0.01).The total score of MAS-A of patients with schizophrenia was negatively correlated with the total score of PANSS (r =-0.547,P ＜ 0.01) and the subscores of negative symptoms (r =-0.518,P ＜ 0.01) and positive symptoms (r =-0.348,P ＜ 0.01).Conclusion Patients with schizophrenia may experience metacognitive deficits which be related to the impairements of theory of mind,this suggest that they share the same neurophysiological basis.