조현병 환자의 위스콘신 카드 분류 검사 첫 4회 시행력의 의의
Clinical Implications of the First 4 Trials on the Wisconsin Card Sorting Test in Patients with Schizophrenia
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives：This study evaluated consecutive response patterns on the first four trials of Wisconsin card sorting test(WCST), not just correct % of each card, in patients with deficit and non-deficit schizophrenia. Methods：The subjects were 145 outpatients with schizophrenia diagnosed by DSM-IV. The deficit(n=37) and non-deficit(n=108) subgroups of the patients were evaluated by retrospective chart review based on the Schedule for the Deficit Syndrome(SDS). Given assign code ‘1’ to the correct responses and ‘0’ to the wrong responses of the WCST, the patients who responded as 1111, 0111, or 0011 on the first four trials were considered as good performers (n=33) and who responded other ways, such as 1010, 0101, etc. were poor performers(n=112). Results：Patients with deficit schizophrenia had lower outcomes in % correct, categories achieved and conceptual level responses than patients with non-deficit schizophrenia. According to the first trials of WCST, poor performers had lower outcomes in all classical indices which were number of trials, % correct, categories achieved and conceptual level responses. Significantly more patients in the deficit group were classified as poor performers on the first four trials. The poor performers failed to chase up the good performers during the first ten trials. The sensitivity and specificity of poor/good performance criteria predicting deficit or non-deficit schizophrenia was 89.2% and 26.9%, respectively. Conclusion：The response patterns of the first four trials in WCST could be an index reflecting the whole WCST performance and predict deficit symptoms better than non-deficit ones in schizophrenia.
Abstract
Objectives：This study evaluated consecutive response patterns on the first four trials of Wisconsin card sorting test(WCST), not just correct % of each card, in patients with deficit and non-deficit schizophrenia. Methods：The subjects were 145 outpatients with schizophrenia diagnosed by DSM-IV. The deficit(n=37) and non-deficit(n=108) subgroups of the patients were evaluated by retrospective chart review based on the Schedule for the Deficit Syndrome(SDS). Given assign code ‘1’ to the correct responses and ‘0’ to the wrong responses of the WCST, the patients who responded as 1111, 0111, or 0011 on the first four trials were considered as good performers (n=33) and who responded other ways, such as 1010, 0101, etc. were poor performers(n=112). Results：Patients with deficit schizophrenia had lower outcomes in % correct, categories achieved and conceptual level responses than patients with non-deficit schizophrenia. According to the first trials of WCST, poor performers had lower outcomes in all classical indices which were number of trials, % correct, categories achieved and conceptual level responses. Significantly more patients in the deficit group were classified as poor performers on the first four trials. The poor performers failed to chase up the good performers during the first ten trials. The sensitivity and specificity of poor/good performance criteria predicting deficit or non-deficit schizophrenia was 89.2% and 26.9%, respectively. Conclusion：The response patterns of the first four trials in WCST could be an index reflecting the whole WCST performance and predict deficit symptoms better than non-deficit ones in schizophrenia.
참고문헌 (45)
- American Psychiatric Association, "American Psychiatric Association. DSM-5 Task Force. Diagnostic and statistical manual of mental disorders: DSM-5" (2013), American Psychiatric Association
- Tandon R, "Schizophrenia, “just the facts” 4. Clinical features and conceptualization", Schizophr Res, 110, pp.1~23 (2009)
- Gold JM, "Cognitive deficits as treatment targets in schizophrenia", Schizophr Res, 72, pp.21~28 (2004)
- Lepage M, "Neurocognition: clinical and functional outcomes in schizophrenia", Can J Psychiatry, 59, pp.5~12 (2014)
- Hunter R, "Negative symptoms and psychosocial functioning in schizophrenia: neglected but important targets for treatment", Eur Psychiatry, 27, pp.432~436 (2012)
- Nuechterlein KH, "Identification of separable cognitive factors in schizophrenia", Schizophr Res, 72, pp.29~39 (2004)
- Reichenberg A, "The assessment of neuropsychological functioning in schizophrenia", Dialogues Clin Neurosci, 12, pp.383~392 (2010)
- Strauss ME, "Relations of symptoms to cognitive deficits in schizophrenia", Schizophr Bull, 19, pp.215~231 (1993)
- Nieuwenstein MR, "Relationship between symptom dimensions and neurocognitive functioning in schizophrenia: a meta-analysis of WCST and CPT studies. Wisconsin Card Sorting Test. Continuous Performance Test", J Psychiatr Res, 35, pp.119~125 (2001)
- McDowd J, "The association between verbal memory, processing speed, negative symptoms and functional capacity in schizophrenia", Psychiatry Res, 187, pp.329~334 (2011)
- Gold JM, "Negative symptoms and the failure to represent the expected reward value of actions:behavioral and computational modeling evidence", Arch Gen Psychiatry, 69, pp.129~138 (2012)
- Yu M, "Neurocognitive impairments in deficit and non-deficit schizophrenia and their relationships with symptom dimensions and other clinical variables", PLoS One, 10, pp.1~16 (2015)
- Ergul C, "Negative symptom subgroups have different effects on the clinical course of schizophrenia after the first episode: a 24-month follow up study", Eur Psychiatry, 30, pp.14~19 (2015)
- Hornig T, "Neuropsychological and cerebral morphometric aspects of negative symptoms in schizophrenia:negative symptomatology is associated with specific mnestic deficits in schizophrenic patients", BMC Psychiatry, 14, pp.326~ (2014)
- Zakzanis KK, "Neuropsychological correlates of positive vs. negative schizophrenic symptomatology", Schizophr Res, 29, pp.227~233 (1998)
- Heaton RK, "Wisconsin Card Sorting Test manual. Rev. and expanded" (1993), Psychological Assessment Resources
- Polgar P, "Executive function in deficit schizophrenia:what do the dimensions of the Wisconsin Card Sorting Test tell us?", Schizophr Res, 122, pp.85~93 (2010)
- Abbruzzese M, "Performance on the Wisconsin Card Sorting Test in schizophrenia: perseveration in clinical subtypes", Psychiatry Res, 64, pp.27~33 (1996)
- Haut MW, "On the nature of Wisconsin Card Sorting Test performance in schizophrenia", Psychiatry Res, 65, pp.15~22 (1996)
- Hartman M, "Wisconsin Card Sorting Test performance in schizophrenia: the role of working memory", Schizophr Res, 63, pp.201~217 (2003)
- Stratta P, "Schizophrenic patients use context-independent reasoning more often than context-dependent reasoning as measured by the cognitive bias task(CBT): a controlled study", Schizophr Res, 37, pp.45~51 (1999)
- Prentice KJ, "The Wisconsin Card Sorting impairment in schizophrenia is evident in the first four trials", Schizophr Res, 106, pp.81~87 (2008)
- Vogel SJ, "Using negative feedback to guide behavior: impairments on the first 4 cards of the Wisconsin Card Sorting Test predict negative symptoms of schizophrenia", Schizophr Res, 151, pp.97~101 (2013)
- American Psychiatric Association, "American Psychiatric Association. Task Force on DSM-IV. Diagnostic and statistical manual of mental disorders: DSM-IV-TR" (2000), American Psychiatric Association
- Loong JWK, "The Wisconsin Card Sorting Test" (1990), Wang Neuropsychological Laboratorory
- Cuesta MJ, "Schizophrenic syndrome and Wisconsin Card Sorting Test dimensions", Psychiatry Res, 58, pp.45~51 (1995)
- Morris RG, "Problem solving in schizophrenia: a specific deficit in planning ability", Schizophr Res, 14, pp.235~246 (1995)
- Greve KW, "Can perseverative responses on the Wisconsin Card Sorting Test be scored accurately?", Arch Clin Neuropsychol, 8, pp.511~517 (1993)
- Kirkpatrick B, "The Schedule for the Deficit syndrome: an instrument for research in schizophrenia", Psychiatry Res, 30, pp.119~123 (1989)
- 황복진, "한국판 결핍증후군 진단지침의 표준화 연구", 생물치료정신의학, 13(2), pp.245~258 (2007), 대한생물치료정신의학회
- Bilder RM, "Neuropsychology of first-episode schizophrenia:initial characterization and clinical correlates", Am J Psychiatry, 157, pp.549~559 (2000)
- Lucas S, "Neuropsychological correlates of symptom profiles in first episode schizophrenia", Schizophr Res, 71, pp.323~330 (2004)
- Stratta P, "Processing of context information in schizophrenia:relation to clinical symptoms and WCST performance", Schizophr Res, 44, pp.57~67 (2000)
- Banno M, "Wisconsin Card Sorting Test scores and clinical and sociodemographic correlates in Schizophrenia:multiple logistic regression analysis", BMJ Open, 2, pp.1~8 (2012)
- Bazin N, "Context-dependent information processing in patients with schizophrenia", Schizophr Res, 45, pp.93~101 (2000)
- Strauss GP, "Deficits in positive reinforcement learning and uncertainty-driven exploration are associated with distinct aspects of negative symptoms in schizophrenia", Biol Psychiatry, 69, pp.424~431 (2011)
- Hartman M, "Working memory and schizophrenia: evidence for slowed encoding", Schizophr Res, 59, pp.99~113 (2003)
- Buchanan RW, "Persistent negative symptoms in schizophrenia:an overview", Schizophr Bull, 33, pp.1013~1022 (2007)
- Burton CZ, "Neurocognitive insight and objective cognitive functioning in schizophrenia", Schizophr Res, 171, pp.131~136 (2016)
- Greve KW, "The role of attention in Wisconsin Card Sorting Test performance", Arch Clin Neuropsychol, 11, pp.215~222 (1996)
- Bozikas VP, "Relationship between psychopathology and cognitive functioning in schizophrenia", Compr Psychiatry, 45, pp.392~400 (2004)
- Barder HE, "10 year course of IQ in first-episode psychosis: relationship between duration of psychosis and long-term intellectual trajectories", Psychiatry Res, 225, pp.515~521 (2015)
- Hedman AM, "IQ change over time in schizophrenia and healthy individuals: a meta-analysis", Schizophr Res, 146, pp.201~208 (2013)
- Cameron AM, "Working memory correlates of three symptom clusters in schizophrenia", Psychiatry Res, 110, pp.49~61 (2002)
- Dieci M, "Non-selective impairment of Wisconsin Card Sorting Test performance in patients with schizophrenia", Schizophr Res, 25, pp.33~42 (1997)