慢性精神分裂症患者认知功能损伤的影响因素及其重复经颅磁刺激干预
文献类型：学位论文
| 作者 | 廖翠青 |
| 答辩日期 | 2023-12 |
| 文献子类 | 继续教育硕士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 王冬梅 |
| 关键词 | 精神分裂症 认知功能 童年创伤 反刍思维 重复经颅磁刺激 |
| 学位名称 | 理学硕士 |
| 学位专业 | 健康心理学 |
| 其他题名 | Factors influencing cognitive impairment in patients with chronic schizophrenia and its intervention with repetitive transcranial magnetic stimulation |
| 中文摘要 | BACKGROUND AND OBJECTIVE: Schizophrenia is a serious mental disorder affecting about 24 million people worldwide, with a high incidence and disability rate, which imposes a heavy burden on individuals, families, and society. Cognitive impairment is one of the core symptoms of schizophrenia, and its pathological mechanisms are still unclear, and effective interventions for cognitive impairment in schizophrenic patients are still being explored. The aim of this study was to investigate the influencing factors of cognitive impairment in patients with chronic schizophrenia, as well as to explore the effectiveness and safety of long-term repetitive transcranial magnetic stimulation in intervening on patients' clinical symptoms and cognitive functions. METHODS: Study 1 was a cross-sectional study using the Childhood Trauma Questionnaire, the Rumination Thinking Scale, the Insomnia Severity Index, and the Repeatable Battery for the Assessment of Neuropsychological State to measure scales and compare between-group differences in 132 patients with schizophrenia and 78 healthy controls. Positive and Negative Syndrome, Hamilton Depression Scale, and Hamilton Anxiety Scale for the patients with schizophrenia, and the use of correlation analysis and mediation analysis to explore the relationship between each psychological factor and cognitive impairment. Study 2 was a longitudinal study with a single-arm design, in which 61 patients with chronic schizophrenia who met the enrolment criteria underwent repeated transcranial magnetic stimulation treatment for 8 months, and the changes in clinical symptoms, rumination, sleep, anxiety and depression, and cognitive function were compared before and after treatment by paired-samples t-test and multiple regression analysis, to explore the effectiveness of long-term repeated transcranial magnetic stimulation in improving cognitive impairment, and to clarify the contribution of each related factor. RESULTS: The study obtained the following findings: (1) Chronic schizophrenic patients have significant cognitive impairment. The total childhood trauma score was significantly negatively correlated with the total cognitive functioning score and all cognitive subscales; sleep disturbances as well as symptom rumination in ruminative thinking were significantly negatively correlated with the spatial structure of cognitive functioning; (2) ruminative thinking was a complete mediator between childhood traumatic experiences and cognitive functioning; (3) 8 months of repetitive transcranial magnetic stimulation treatment was effective on positive symptoms, Hamiltonian depression, and Hamiltonian anxiety and ruminative thinking total scores in patients with schizophrenia; 8 months of repetitive transcranial magnetic stimulation treatment significantly improved cognitive functioning total scores, immediate memory, spatial structure, and delayed memory scores in patients with schizophrenia, but did not affect language, or attention. CONCLUSION: Childhood traumatic experiences, ruminative thinking, and sleep disorders affect cognitive functioning in patients with chronic schizophrenia. Chronic repetitive transcranial magnetic stimulation has a significant effect on the improvement of cognitive function in schizophrenia, and the total score of psychotic symptoms and the improvement of rumination are closely related to the improvement of cognitive function. |
| 英文摘要 | 背景与目的：精神分裂症是一种严重的精神疾患，影响到全球约 2400 万人，其发病率和致残率较高，给个人、家庭、社会都带来沉重的负担。认知功能损伤是精神分裂症的核心症状之一，其病理机制尚不清楚，目前对于精神分裂症患者认知损伤的有效干预手段还在探索之中。本研究旨在探讨慢性精神分裂症患者认知功能损伤的影响因素，同时探索长期重复经颅磁刺激对患者临床症状和认知功能干预的有效性和安全性。 方法：研究一为横断面研究，采用童年创伤问卷、反刍思维量表、失眠严重 指数、重复成套神经心理状态测验对 132 例精神分裂症患者和 78 例健康对照进行量表测量和组间差异比较，采用阳性和阴性症状量表，汉密尔顿抑郁量表，汉密尔顿焦虑量表对精神分裂症患者进行测评，使用相关分析和中介分析探索各心理因素与认知功能损伤的关系。研究二为单臂设计的纵向研究，对符合入组标准 的 61 例慢性精神分裂症患者进行 8 个月的重复经颅磁刺激治疗，通过配对样本 t 检验及多元回归分析比较治疗前后患者在临床症状、反刍思维、睡眠情况、焦虑抑郁情况、认知功能的变化，探究长期重复经颅磁刺激对认知损伤改善的有效性，并明确各相关因素的贡献。 结果：研究得到以下几点发现：(1) 慢性精神分裂症患者存在着明显的认知功能损伤。童年创伤总分与认知功能总分及所有认知子维度呈显著负相关；睡眠障碍以及反刍思维中的症状反刍均与认知功能的空间结构存在显著负相关；(2) 反刍思维在童年创伤经历与认知功能之间存在完全中介作用；(3) 8 个月的重复经颅磁刺激治疗对精神分裂症患者的阳性症状、汉密尔顿抑郁、汉密尔顿焦虑、反刍思维总分均有显著改善；8 个月的重复经颅磁刺激治疗对精神分裂症患者的认知功能总分，即刻记忆，空间结构以及延迟记忆评分有显著改善，但不影响语言，注意力。 结论：童年创伤经历、反刍思维、睡眠障碍等因素会影响慢性精神分裂症患者的认知功能。慢性重复经颅磁刺激治疗对于精神分裂症的认知功能的改善有显著效果，并且精神病症状的总分与反刍思维的改善与认知功能的改善密切相关。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/48198]  |
| 专题 | 心理研究所_健康与遗传心理学研究室 |
| 推荐引用方式 GB/T 7714 | 廖翠青. 慢性精神分裂症患者认知功能损伤的影响因素及其重复经颅磁刺激干预[D]. 中国科学院心理研究所. 中国科学院大学. 2023. |
入库方式： OAI收割
来源：心理研究所
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