智能手机游戏对慢性精神分裂症患者认知功能影响及性别差异

The impact of smartphone games on cognitive function in patients with chronic schizophrenia and gender differences

中文关键词:  精神分裂症  手机游戏  认知功能  性别差异  即刻记忆

英文关键词:Schizophrenia  smartphone games  cognitive function  gender differences  immediate memory

中文摘要:

      背景 慢性精神分裂症患者常伴随认知功能损害。传统认知康复训练存在形式单一、依从性差等问题,迫切需要开发出新的认知干预方法。目的 探讨智能手机游戏对慢性精神分裂症患者认知功能的干预效果,并分析不同性别患者在认知功能改善中的差异。方法 前瞻性队列研究,选取2021年03月至2021年10月,在安徽医科大学附属巢湖医院精神科住院治疗的30例慢性精神分裂症患者为研究对象,符合《国际疾病分类第10版》(ICD-10)中慢性精神分裂症诊断标准,病程≥5年。所有入组患者在常规抗精神病药物治疗基础上,给予手机游戏干预,每周5次,每次30分钟,持续12周。干预前后采用可重复的成套神经心理状态测量(RBANS)评估患者认知功能,采用阳性与阴性症状量表(PANSS)评估患者精神症状,智能手机游戏成瘾评估量表(PMGQ)评估患者成瘾症状。结果 本研究最终共有13例女性患者、13例男性患者完成全部干预。两组性别、年龄、受教育年限、首次发病年龄、BMI及药物剂量,差异均无统计学意义(P>0.05)。干预前,两组在RBANS总评分上差异无统计学意义(女性组331.08±71.46分,男性组299.31±63.14分,P>0.05)。干预12周后,女性组和男性组在RBNAS评分,总分、即刻记忆、言语功能、延时记忆均具有时间效应(P均<0.05)。在即刻记忆评分上,女性组和男性组还存在着组间效应(F组间=5.71,P<0.05)。女性组即刻记忆评分在干预3周、6周、9周、12周时间点上,得分均高于男性组(P<0.05)。干预12周后,女性组和男性组在PANSS、PMGQ评分时间效应、组间效应及交互效应上差异无统计学意义(P均＞0.05)。结论 智能手机游戏可有效改善慢性精神分裂症患者的即刻记忆、言语功能、延时记忆等认知功能,且存在性别差异,女性在即刻记忆上改善更显著。智能手机游戏干预不影响患者精神症状,且不会导致患者出现手机游戏成瘾。

英文摘要:

      Background Patients with chronic schizophrenia often suffer from cognitive impairment. Traditional cognitive rehabilitation training has problems such as a single form and poor compliance, making it urgent to develop new cognitive intervention methods. Objective To explore the effect of smartphone games on the cognitive function of patients with chronic schizophrenia and analyze the differences in cognitive function improvement between different genders. Methods: This study was a prospective cohort study. Thirty patients with chronic schizophrenia (duration more than 5 years) who were hospitalized in the Department of Psychiatry, Chaohu Hospital of Anhui Medical University from March 2021 to October 2021 were selected as the research subjects. All enrolled patients received smartphone game intervention in addition to conventional antipsychotic drug treatment, five times a week, 30 minutes each time, for 12 weeks. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess the cognitive function of the patients before and after the intervention, the Positive and Negative Syndrome Scale (PANSS) was used to assess the mental symptoms of the patients, and the Smartphone Game Addiction Questionnaire (PMGQ) was used to assess the addiction symptoms of the patients. Results A total of 13 female and 13 male patients completed the entire intervention. There were no statistically significant differences in gender, age, years of education, age of first onset, BMI and drug dosage between the two groups (P > 0.05). Before the intervention, there was no statistically significant difference in the total score of RBANS between the two groups (female group: 331.08 ± 71.46 points, male group: 299.31 ± 63.14 points, P > 0.05). After 12 weeks of intervention, both the female and male groups showed time effects in RBANS scores, total scores, immediate memory, verbal function, and delayed memory (all P < 0.05). In the immediate memory score, there was also an intergroup effect (Fgroup = 5.71, P < 0.05). The immediate memory score of the female group was higher than that of the male group at the 3-week, 6-week, 9-week, and 12-week time points (all P < 0.05). After 12 weeks of intervention, there were no statistically significant differences in the time effect, intergroup effect, and interaction effect of PANSS and PMGQ scores between the female and male groups (all P > 0.05). Conclusion: Smartphone games can effectively improve the cognitive functions such as immediate memory, verbal function, and delayed memory of patients with chronic schizophrenia, and there are gender differences, with females showing more significant improvement in immediate memory. Smartphone game intervention does not affect the mental symptoms of patients and does not lead to smartphone game addiction.