Decision Making In Adolescent Schizophrenia With Positive And Negative Symptoms

Objective: Schizophrenia is a severe mental disorder with unclear pathogenesis.Decision-making ability is an important cognitive function of individual.Considering that the current decision-making ability of adolescent schizophrenia is not sufficient,Negative and positive decision-making of different types of symptoms is rare,this study using Intertemporal-choice Test,Iowa Gambling Task and Game of Dice Task to explore the decision making ability of patients with the purpose of finding different patients with adolescent schizophrenia Whether the decision making ability is damaged or not,whether the negative and positive adolescents with different symptoms have the same decision damage performance,and provide a basis for further clinical application.Methods: 64 cases of adolescent schizophrenia and 46 healthy controls were studied using Intertemporal-choice Test,Iowa Gambling Task and Game of Dice Task.At the same time the use of positive and negative symptoms rating scale for adolescents of different symptoms of schizophrenia patients group,positive symptom group of 34 cases,the group of 30 cases of negative symptoms,compared with 46 cases of healthy controls.All statistical analyses were conducted using SPSS 16.0.An independent sample t-test was used for the analysis of continuous variables within groups or between groups in the patient group and the control group;gender differences were compared using the χ2 test.The analysis of variance was used to compare the correlation data between the negative,positive and control groups.Pearson correlation analysis was used to analyze the relationship between each decision-making ability index of the patient group and each neuropsychological test result.The three groups were matched in terms of gender,age and education years.Results:Results 1.In adolescent schizophrenia group and healthy control group(1)Intertemporal-choice test The rate of delaying options in adolescent schizophrenia group was significantly higher than that of the healthy control group(P <0.05),reflected in the low amount group(16.41±26.64%vs 7.61±16.74%;P<0.05),middle amount group(30.47±33.27%vs18.48±21.72%;P<0.05)and total now condition(30.21±27.91%vs20.41±18.07%;P<0.05)under the now selection condition with immediate options;in the low amount group(18.23±27.49%vs5.80±12.77%;P<0.01)and the middle amount group(28.12±31.41%vs17.03±20.33%;P<0.05)and total not-now condition(29.69±28.33%vs20.77±18.09%;P<0.05)under the no immediate options not-now the selection condition;In the overall(29.95±27.52%vs 20.59± 16.96%;P<0.05).(2)Iowa Gambling Task: the net score of adolescent schizophrenia groups in block 5 was significantly lower than that of normal control group(-0.81±7.13 vs2.74±5.89;P<0.01),there was no significant difference in other blocks(P>0.05).Analysis of the decision-making process of the two groups found that the net scores of block3 to block5 in the adolescent schizophrenia group were all greater than that of block1(P<0.05),and the net scores of block2 to block5 in the control group were all greater than block1(P<0.05).(3)Game of Dice Task: adolescent schizophrenia groups in a single number dice average number was significantly higher than in normal control group(2.70±3.02 vs 0.48±0.98;P<0.01);in three number dice average number was significantly lower than in normal control group(4.25±3.21 vs5.91±3.51;P<0.05);In the overall net score,adolescent schizophrenia groups were significantly lower than the control group(6.50±9.14vs10.48±7.43;P<0.05).Results 2.In adolescent schizophrenia positive symptom group,negative symptom group and healthy control group(1)Intertemporal-choice test The rate of delaying options of adolescent schizophrenia negative symptom group was significantly higher than that of the healthy control group,(P < 0.05).reflected in the middle amount group(37.78±34.44%vs 18.48±21.72%;P<0.05)and total now condition(35.00±28.41%vs20.41±18.07%;P<0.05)with immediate options;Under the condition of not-now,the low amount group(23.89±31.47%vs5.8±12.77%;P<0.05),middle amount group(30.00±32.87%vs17.03±20.33%;P<0.05)and total not-now condition(33.15±30.27%vs 20.77±18.09%;P<0.05);In the overall(34.07±28.65%vs20.59±16.96%;P<0.05).There was no significant difference between the positive symptom group and the control group in the three conditions(P>0.05);There was no significant difference between the positive symptom group and the negative symptom group(P> 0.05).(2)Iowa Gambling Task: The net score of in block 5 whether the positive symptom group(-0.47±6.50vs2.74±5.89;P<0.05)or the negative group symptom group(-1.20±7.89vs2.74±5.89;P<0.05)was significantly lower than that of control group;there was no obvious difference in other blocks(P>0.05).Analysis of the decision-making process of the patient group found that the positive symptoms in the block2 to block5 net scores were greater than block1(P <0.05);the difference between the different blocks of the negative symptoms group was not significant(P> 0.05).(3)Game of Dice Task: On the average number of a single number of dice,regardless of the positive symptoms group(2.56±2.83vs0.48±0.98;P<0.05)or the symptom group of negative group(2.87±3.27vs0.48±0.98;P<0.05),Both were significantly higher than the control group(P< 0.05).On the average number of three dice,the negative group was obviously lower than that of the control group(4.50±3.88vs5.91±3.51;P<0.05);The difference between the positive symptom group and the normal control group was not significant(P> 0.05).Under the overall net score,the negative symptom group was obviously lower than the control group(6.27±9.57vs10.48±7.43;P<0.05),there was no obvious difference between the positive symptom group and the control group(P> 0.05).Conclusion:(1)Compared with the control group,adolescent schizophrenics were impaired in intertemporal choice,decision making under ambiguity and decision making under risk.(2)After grouped patients to negative symptoms group and positive symptoms group were found:In the intertemporal choice,there were significant differences between the negative symptom group and the control group,while the positive symptom group was not significantly impaired compared with the control group;In the IGT,the negative and positive symptoms performed similarly,with a significant bias towards block 5,and a significant difference from the normal control group,suggesting that the decision-making ability with undefined risk may necessarily be impaired,The change of the decision-making mode of the negative symptom group is not obviously impaired,which may be more serious;In the GDT,negative symptoms and positive symptom group performance similar to the option were significantly tend to risk,but the group of negative symptoms showed a worse overall performance,the results showed that both positive and negative symptom group had impaired decision-making ability,but the negative symptom group was more severely damaged.