ABSTRACT
Objective:To explore the social and physical anhedonia and its relationship to intrinsic motivation in patients with schizophrenia.Methods:One hundred and twenty-five stable schizophrenic patients from three psychiatric hospitals in Hefei, Wuhu and Beihai, and 101 healthy controls from same communities were recruited.All subjects completed Chinese version of revised social anhedonia scale(RSAS-C), Chinese version of revised physical anhedonia scale(RPAS-C) and intrinsic motivation inventory for schizophrenia research(IMI-SR), while positive and negative syndrome scale(PANSS) and Calgary depression scale for schizophrenia(CDSS) were used to assess the clinical symptoms of schizophrenic patients.All analyses were conducted by SPSS 26.0 software.The Mann-Whitney U test and covariance analysis were used for comparison between the groups, and Spearman correlation and multiple logistic regression analysis were used to explore the association between the anhedonia and intrinsic motivation in schizophrenics. Results:Compared with controls, the RSAS-C (10.00(6.00, 14.00) vs 11.00(8.00, 15.00), Z=-2.187, P<0.05) and RPAS-C (12.00(7.50, 20.00) vs 16.00(10.00, 23.00), Z=-3.026, P<0.01) scores in patients were higher, but the differerce between the groups disappeared after controlling age, sex and years of education.The IMI-SR perceived choice subscore (31.00(28.00, 39.00 vs 36.00(31.00, 42.00), Z=-3.172, P<0.01) were lower, while value/usefulness subscores (41.00(35.00, 45.00) vs 36.00(32.00, 42.00), Z=-3.387, P<0.01) were higher in patients than those in controls, and there was no significant difference between the total score and interest/enjoyment subscore(both P<0.05). In patents, Spearman correlation analysis showed that the RSAS-C and RPAS-C scores were significant negatively correlated with the IMI-SR total scores and interest/enjoyment subscore, perceived choice and value/usefulness( r=-0.193--0.364, all P<0.05), which still existed after controlling age, sex, years of education, course of disease, antipsychotic dose, and scores of PANSS and CDSS.Logistic regression analysis showed that the score of RSAS-C( B=-0.096, 95% CI=0.836-0.998, P=0.025) and perceived choice subscore( B=-0.110, 95% CI=0.823-0.974, P=0.010) had negative effects on the IMI-SR total score. Conclusion:There is a correlation between anhedonia and intrinsic motivation in patients with schizophrenia, the higher the social anhedonia, the lower the intrinsic motivation to participate in cognitive activities, suggesting that intervention for social anhedonia may have significance in improving the intrinsic motivation of patients with cognitive rehabilitation therapy.
ABSTRACT
Objective:To explore the relationship between the childhood trauma and neruocognition in patients with schizophrenia.Methods:Sixty-two patients with schizophrenic were selected from Anhui mental health center, and sixty-three community health controls were selected. All subjects were assessed with the childhood trauma questionnaire (CTQ), Wisconsin card sorting Test (WCST), attention network test (ANT), verbal fluency test (VFT) and digit span test (DST). SPSS 17.0 was used for statistical analysis. t-test was used to compare the measurement data of normal distribution and Mann-Whitney U test was used to compare the measurement data of non-normal distribution. Spearman correlation analysis was used to analyze the relationship between CTQ score and cognitive function score. Results:Compared with health controls(34.00(30.00, 37.00), 6.00 (5.00, 7.00), 5.00(5.00, 5.00), 5.00(5.00, 5.00), 9.00(6.00, 11.00), 7.00(6.00, 10.00)), the total score of CTQ, subscores of emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect in patients with schizophrenia were significantly increased (48.50(37.75, 57.00), 9.00(6.00, 12.25), 7.00(5.00, 9.25), 5.50(5.00, 7.25), 13.00 (9.00, 16.25), 11.00(8.00, 13.00)) ( Z=-4.781--6.724, all P<0.01). Compared with the control group, the number of WCST classification completed in the patient group was lower, while the number of wrong answers, continuous answers and persistent errors increased ( Z=-5.655--6.060, all P< 0.01). The correct rate of ant decreased, but the reaction time increased ( Z=-5.796, -6.094, all P< 0.01). VFT and DST scores were decreased ( Z=-3.492--8.499, both P< 0.01). In patients with schizophrenia, CTQ sexual abuse subscore were negatively correlated with completed categories scores ( r=-0.384) and positively correlated with total errors ( r=0.360), perseverative responses( r=0.394) and perseverative errors ( r=0.381) on WCST(all P<0.01). CTQ physical neglect scores were negatively correlated with the ANT correct ratio( r=-0.400) and conflict resolution( r=-0.417) (all P<0.01). CTQ emotional neglect scores were negatively correlated with VFT scores( r=-0.345) ( P<0.01). The significant associations remained after controlling for age, education and PANSS scores. Conclusion:Patients with schizophrenia experience more traumatic events in their early years and have extensive cognitive defects. The childhood trauma has negative effects on cognitive flexibility, attention, memory and speech function in patients with schizophrenia.However, the positive correlation between childhood trauma and executive conflict of attention network needs to be further verified and explored.