智能手机游戏对慢性精神分裂症患者认知功能的影响及性别差异

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  智能手机游戏  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有认知功能受损。传统认知康复训练存在形式单一、患者依从性差等问题，迫切需要开发新的认知干预方法。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，并分析不同性别的患者认知功能改善的差异，以期为慢性精神分裂症认知功能的改善提供参考。方法 本研究为前瞻性队列研究。选取2021年3月—10月在安徽医科大学附属巢湖医院精神科住院治疗、符合《国际疾病分类（第10版）》（ICD-10）精神分裂症诊断标准、病程≥5年的30例患者为研究对象。所有患者均在常规抗精神病药物治疗的基础上，接受为期12周、每周5次、每次1 h的智能手机游戏干预。分别于基线期和干预3、6、9、12周，采用重复性成套神经心理状态测验（RBANS）评定认知功能，采用阳性和阴性症状量表（PANSS）评定精神病性症状，采用智能手机游戏成瘾评估量表（PMGQ）评定成瘾症状。结果 最终共26例（86.67%）患者完成本研究，其中女性和男性各13例。女性组和男性组RBANS即刻记忆因子评分的时间效应、组间效应以及时间与组间的交互效应均有统计学意义（F=36.682、5.712、3.090，P<0.05或0.01），两组言语、延迟记忆因子评分以及总评分的时间效应均有统计学意义（F=3.841、6.149、15.372，P<0.05或0.01）。两组PANSS总评分的时间效应和组间效应均无统计学意义（F=2.041、0.623，P均>0.05），时间与组间的交互效应有统计学意义（F=5.728，P<0.01）。两组PMGQ总评分的时间效应、组间效应以及时间与组间的交互效应均无统计学意义（F=2.672、0.166、0.642，P均>0.05）。结论 智能手机游戏干预可能有助于改善慢性精神分裂症患者的认知功能（尤其是即刻记忆、言语和延迟记忆），且女性患者获益可能更高。智能手机游戏干预未诱发游戏成瘾，但未观察到其对精神病性症状的明显改善。

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 intervention effect of smartphone games on the cognitive function of patients with chronic schizophrenia， and to analyze the differences in cognitive function improvement between patients of different genders， in order to provide references for the cognitive function intervention of these patients.Methods This study was a prospective cohort study. A total of 30 patients who were hospitalized in the Psychiatry Department of Chaohu Hospital Affiliated to Anhui Medical University from March to October 2021， met the diagnostic criteria for schizophrenia as defined in the International Classification of Diseases， tenth edition （ICD-10）， and had a disease duration of above 5 years， were selected as the research subjects. All patients received smartphone game intervention for 12 weeks， 5 times a week， each session lasting 1 hour， in addition to conventional antipsychotic drug treatment. At the baseline and at 3， 6， 9， and 12 weeks of the intervention， the cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status （RBANS）， the Positive and Negative Syndrome Scale （PANSS） was used to assess mental symptoms， and the Problematic Mobile Gaming Questionnaire （PMGQ） was used to assess addiction symptoms.Results A total of 26 patients （86.67%） completed the study， including 13 females and 13 males. The time effects， group effects， and interaction effect between time and group for the immediate memory factor score of RBANS in the female group and the male group were all statistically significant （F=36.682， 5.712， 3.090， P<0.05 or 0.01）， and the time effects and group effects for the verbal and delayed memory factors as well as the total score in both groups were also statistically significant （F=3.841， 6.149， 15.372， P<0.05 or 0.01）. The time effects and group effects of the total score of PANSS in both groups had no statistical significance （F=2.041， 0.623， P>0.05 for both）， and the interaction effect between time and group was statistically significant （F=5.728， P<0.01）. The time effects， group effects， and interaction effect of the total score of PMGQ in both groups were all without statistical significance （F=2.672， 0.166， 0.642， P>0.05 for both）.Conclusion Smartphone game intervention may help improve the cognitive function of patients with chronic schizophrenia （especially immediate memory， verbal function， and delayed memory）， and the benefits are greater for female patients. The smartphone game intervention did not induce game addiction， but no significant improvement in psychotic symptoms was observed. ［Funded by Excellent Young Talents Support Program of Anhui Provincial Department of Education （number， gxyqZD2022022）； www.chictr.org.cn number， ChiCTR2100044113］