【摘要】 目的调查伴与不伴强迫症状的儿童精神分裂症患者之间病后认知功能和病前行为特征的差异。方法选取儿童精神分裂症患者149例为患者组,72名正常儿童为对照组。根据学龄儿童情感障碍和精神分裂症问卷(the schedule for affective disorders and schizophrenia for school-age children-present and lifetime version,K-SADS-PL)将患者组患儿分为伴强迫症状组(70例)与不伴强迫症状组(79例)。采用Achenbach儿童行为量表(child behaviour check-list,CBCL)回顾性调查所有入组儿童6~10岁的行为特征;采用中国韦氏儿童智力测验、Stroop色—词测验、连线测验、视觉空间记忆、迷宫测验对所有入组儿童进行认知功能的评估。结果CBCL量表测评显示,两患者组既往行为问题总分均高于对照组(P<0.01),社会能力总分均低于对照组(P<0.05);伴强迫组学校情况(P<0.01)、分裂强迫(P<0.01)以及体诉因子分(P<0.01)均高于不伴强迫组。认知功能测评显示,两患者组所有因子评分均低于对照组(P<0.05),伴强迫组常识(P<0.01)、木块(P<0.01)、Stroop色—词关联测验(P<0.01)以及视觉空间记忆评分(P<0.01)低于不伴强迫组。病前行为特征与病后认知功能相关分析显示,伴强迫组社会能力总分与类同评分呈正相关(r=0.31,P<0.01);不伴强迫组行为问题总分与木块评分(r=-0.31,P<0.01)、拼凑评分(r=-0.32,P<0.01)呈负相关。结论伴强迫症状的首发儿童精神分裂症患者病前存在更多的行为问题,病后认知功能更差。伴与不伴强迫症状的首发儿童精神分裂症患者病后认知功能均与病前行为问题、社会能力存在相关关系。更多还原

【Abstract】 ObjectiveTo investigate cognitive function and behavior characteristics in the childhood onset schizophrenia patients with or without obsessive-compulsive symptoms.MethodsOne hundred forty-nine schizophrenia children were recruited and 72 healthy children served as children control group. According to the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version(K-SADS-PL), the patients were further divided into two groups, the children with obsessive-compulsive disorder group(70 cases) and the children without obsessive-compulsive disorder group(79 cases). All the children were retrospectively surveyed and the Achenbach’s Child Behavior Check-list(CBCL) was used to assess their social competence and behavioral characteristics at the age from 6-year-old to 10-year-old. The cognitive function was estimated with WISC, STROOP color and word test, trailResults behavior problems were higher(P<0.01), social ability factor scores were lower(P<0.05) and all factor scores in the cognitive function tests were lower(P<0.05) in the two patients groups. Compare to the patients without obsessive-compulsive symptoms, the CBCL factor scores of the school situation(P<0.01), splitting force(P<0.01), and physical complaints(P<0.01) were significantly higher and the scores were significantly lower in the test of common sense(P<0.01), wood(P<0.01), STROOP(P<0.01) and BVMT-R(P<0.01) in those with obsessive-compulsive symptoms. Correlation analysis showed that social competence total scores were positively correlated with similarity in the patients with obsessive-compulsive symptoms(r=0.31, P <0.01); while behavior problems total scores were negatively correlated with wood(r=-0.31,P <0.01) and patchwork(r=-0.32, P <0.01) in the patients without obsessive-compulsive symptoms.ConclusionThe schizophrenia children with obsessive-compulsive symptoms have more behavioral problems in pre-symptom period and their cognitive dysfunction are more severe following onset of the disease. Cognitive function is related to behavioral problems and social competence in the schizophrenia children with or without obsessive-compulsive symptoms.更多还原