精神分裂症和双相障碍的健康一级亲属认知功能的对照研究

摘要

目的 探讨精神分裂症和双相障碍患者的健康一级亲属的认知功能缺陷的异同点.方法 纳入精神分裂症和双相障碍两类患者的健康一级亲属各50名、正常对照组50名.采用数字符号、连线测验( trail marking test,TMT)A和B、数字广度、图形视觉再生、言语流畅性、威斯康星卡片、汉诺塔(Hanoi tower,HOT)评估被试者的注意、记忆和执行功能,比较3组间的差异.结果 3组间数字符号总分、TMT-A时间、数字广度(总分及倒背)、视觉图形再生总分、言语流畅性总分、WSCT持续错误数、HOT总分及完成任务数等成绩的差异均有统计学意义(P＜0.05).两两比较显示,精神分裂症亲属组上述所有指标的成绩均差于正常对照组(P＜0.05),而双相障碍亲属组仅数字符号、TMT-A时间、数字广度总分及倒背、言语流畅性总分均差于正常对照组(P＜0.05),精神分裂症亲属组的图形视觉再生、HOT总分及完成任务数均比双相障碍亲属组差(均P＜0.05).结论 两类患者的健康一级亲属均存在注意、记忆和执行功能等认知缺陷,精神分裂症亲属的认知缺陷更显著,提示认知缺陷既是两类精神疾病共同的遗传易感因素,但又在两类疾病的家系中的遗传负荷有所不同.%Objective To examine the cognitive function in unaffected first-degree relatives of patient of schizophrenia and bipolar disorder. Methods Cognitive function studied in 50 unaffected first-degree relatives of patient of schizophrenia and bipolar disorder and 50 healthy individuals. Digital symbol, trail marking test (TMT), digital span, visual reproduction, verbal fluency, Wisconsin card sorting test (WSCT), Hanoi tower (HOT) were used to assess the attention, memory and execution functions. Result Compare with healthy individuals, relatives from both families of schizophrenia and bipolar disorder showed significant impairment in digital symbol, TMT-A digital span (total and pour), visual reproduction, verbal fluency, WSCT continue error, THO total scorce and finished tasks (P < 0.05). Post Hoc multiple comparisons showed that, compared with controls, the relatives of schizophrenia had worse scores in all tests(P < 0.05) , while bipolar group only had worse scores in digital symbol, TMT-A digital span (total and pour) and verbal fluency. Furthermore, relatives of schizophrenia had worse scores than in visual reproduction, THO total scores and finished tasks compared with relatives of bipolar disorder(P < 0.05). Conclusions The unaffected first-degree relatives from both families of schizophrenia and bipolar disorder have attention, memory and execution function impairment. Furthermore, the relatives of schizophrenia have more severe impairment than those of bipolar disorder, indicating that cognitive deficits may be the common genetic susceptibility factors with different factor loading for those two mental disorders.