目的:精神分裂症与心理理论(ToM)障碍有关,这被定义为对精神状态做出判断的能力,并且与内侧前额叶皮层活动有关。齐拉西酮,但不是氟哌啶醇,已知对内侧前额叶皮层有保护作用。因此,我们假设这两种药物在改善精神分裂症患者的ToM任务表现方面具有不同的疗效.
方法:患有精神疾病诊断和统计手册的患者,第四版(DSM-IV)精神分裂症的性别匹配诊断,疾病的持续时间,和教育随机接受齐拉西酮(n=30)或氟哌啶醇(n=30)。使用阳性和阴性综合征量表以及个人和社会功能量表对所有患者进行评估。使用一阶错误信念任务评估了ToM,二阶错误信念任务,假任务,和读心的任务,按发展的复杂性和难度排序。主要结果是从基线到治疗16周的ToM性能变化。
结果:对于一阶错误信念任务,组间差异无统计学意义(P>0.05)。对于二阶错误信念任务,交互作用显著(P<0.05),仅在齐拉西酮组中,时间的简单效应显示出显着差异(P<0.001)。对于假任务,交互效应不显著(P>0.05)。对于阅读眼中的心灵任务,交互作用显著(P<0.05),仅在齐拉西酮组中,时间的简单效应显示出显着差异(P<0.001)。两组之间的阳性和阴性综合征量表结果相似。在个人和社会功能量表上,齐拉西酮组的表现优于氟哌啶醇组。没有重大安全问题或不良事件。
结论:这项研究的结果表明,齐拉西酮可以改善精神分裂症患者的ToM,并且在改善复杂的ToM以及个人和社会功能方面可能优于氟哌啶醇。
■ChiCTR2200060542。
OBJECTIVE: Schizophrenia is associated with impairment in theory of mind (ToM), which is defined as the ability to make judgments about mental states and is related to medial prefrontal cortical activity. Ziprasidone, but not haloperidol, is known to have a protective effect in the medial prefrontal cortex. Thus, we hypothesized that these 2 drugs would have different efficacy in improving ToM task performance in patients with schizophrenia.
METHODS: Patients with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnosis of schizophrenia matched for sex, duration of illness, and education were randomized to receive ziprasidone (n=30) or haloperidol (n=30). All patients were assessed using the Positive and Negative Syndrome Scale and the Personal and Social Functioning Scale. ToM was assessed using a first-order false belief task, a second-order false belief task, the faux-pas task, and the Reading the Mind in the Eyes Task, in order of developmental complexity and difficulty. The primary outcome was change in ToM performance from baseline to 16 weeks of treatment.
RESULTS: For the first-order false belief task, there were no significant differences between the groups (P>0.05). For the second-order false belief task, the interaction effect was significant (P<0.05), and the simple effect of time showed a significant difference only in the ziprasidone group (P<0.001). For the faux-pas task, the interaction effect was not significant (P>0.05). For the Reading the Mind in the Eyes Task, the interaction effect was significant (P<0.05), and the simple effect of time showed a significant difference only in the ziprasidone group (P<0.001). The Positive and Negative Syndrome Scale results were similar between the groups. The ziprasidone group performed better than the haloperidol group on the Personal and Social Functioning Scale. There were no major safety concerns or adverse events.
CONCLUSIONS: The findings of this
study suggest that ziprasidone could improve ToM and might be superior to haloperidol for improving complex ToM as well as personal and social functioning in patients with schizophrenia.
UNASSIGNED: ChiCTR2200060542.