改良电休克治疗对精神分裂症患者自传体记忆的影响

Autobiographical memory impairment following modified electroconvulsive therapy in patients with schizophrenia

关键词:  精神分裂症  改良电休克治疗  自传体记忆

Key words:  schizophrenia  modified electroconvulsive therapy  autobiographical memory

摘要:

目的探讨改良电休克治疗(modified electroconvulsive therapy, MECT）对精神分裂症患者自传体记忆的影响。方法选取急性期精神分裂症患者92例为研究对象，分为MECT组（40例）和非MECT组（52例）。非MECT组单用抗精神病药物治疗，MECT组在服药的基础上联合MECT治疗10次。两组在基线期、第4周末、第6周末采用经典自传体记忆测验（autobiographical memory test， AMT）的范式评估自传体记忆功能。对不同测量点的数据采用重复测量方差分析和协方差分析的方法进行比较。结果与非MECT组相比，MECT组在第4周末中性词、积极词、消极词诱导的自传体记忆回忆时间更长（F=13.662,P<0.001;F=9.290,P=0.003;F=19.146,P<0.001），中性词、积极词、消极词诱导的自传体记忆分数及AMT总分更低（F=13.225,P<0.001;F=12.823,P=0.001;F=10.281,P=0.002;F=11.405,P=0.001）；MECT组比非MECT组在第6周末中性词诱导的自传体记忆回忆时间更长，回忆分数更低（F=9.872,P=0.002;F=7.402,P=0.008）。MECT组第6周末自传体记忆的回忆时间和回忆分数与基线期比较，差异均无统计学意义（均P＞0.05)。结论MECT治疗可能加重精神分裂症患者的自传体记忆过度概括化程度，延长回忆的时间，特别是对中性词诱导的自传体记忆，但影响短暂而且可逆。

Abstract:

ObjectiveTo examine the effect of modified electroconvulsive therapy(MECT) on autobiographical memory in schizophrenic patients. MethodsNinety-two patients with acute schizo-phrenia were divided into two groups, 40 cases received antipsychotics and 10 times of MECT(MECT group), while other 52 cases received antipsychotics only(non-MECT group). The autobiographical memory was evaluated with the classic autobiographical memory test(AMT) at the baseline, 4 and 6 weeks after treatment in both groups. Repeated measures analysis of variance and covariance analysis were conducted to compare the AMT results at different time points. ResultsCompared with the non-MECT group, the autobiographical memory recall times motivated by neutral words, positive words and negative words in the MECT group were longer(F=13.662,P<0.001;F=9.290,P=0.003;F=19.146,P<0.001), the autobiographical memory recall scores induced by neutral words, positive words, and negative words and the total score of AMT in the MECT group were lower(F=13.225,P<0.001;F=12.823,P=0.001;F=10.281,P=0.002;F=11.405,P=0.001) at 4 weeks after treatment. Compared with the non-MECT group, the autobiographical memory recall time motivated by neutral words of the MECT group was longer, and the recall score was lower(F=9.872,P=0.002;F=7.402,P=0.008) at 6 weeks after treatment. There was no significant difference of any recall time or recall score of autobiographical memory at baseline and 6 weeks after treatment in the MECT group(all P＞0.05). ConclusionMECT treatment may exacerbate the overgeneralization of autobio-graphical memory in schizophrenic patients, and lengthen the recall time, specifically for the autobiographical memory induced by neutral words, but the effect is transient and reversible.