| Objective: Schizophrenia(SZ)is a complex psychiatric disorder with a chronic,relapsing course that is difficult to resolve and is associated with cognitive impairment in addition to common psychotic,positive and negative symptoms.Previous studies have shown that there is a complex relationship between these symptoms,which interact with each other and contribute to the complex clinical manifestations of SZ,but the interaction between these three is still unclear.To this end,this study aims to investigate the network relationships among the three dimensions of positive symptoms,negative symptoms and cognitive function in patients with chronic SZ through network analysis,to investigate the symptom network structure of chronic SZ,and to clarify its core and bridging symptoms,so as to provide a theoretical basis for an in-depth understanding of the psychopathological mechanisms and clinical interventions in chronic SZ.Methods: The mean age of the patients was 48.30 ± 13.70 years,of which 750(60.5%)were male,and the mean duration of the disease was 18.90±10.50 years.(ii)Results of univariate analysis: interpersonal relationships and social activities were influential factors for positive symptoms;interpersonal relationships,disease duration and alcohol consumption were influential factors for negative symptoms;social activities,educational level,smoking and disease duration were influential factors for cognitive function.(iii)Network analysis results: positive symptoms,negative symptoms and cognitive function constitute the central nodes of the network model:nodes P1("delusions"),N3("emotional communication disorder"),M8("abstract-word similarity");the bridging nodes are: nodes P2("conceptual disorder"),N7("stereotypical thinking"),N5("abstract thinking concept "),N6("lack of spontaneity and fluency in conversation"),and M8("abstract-word similarity").The network stability coefficient was 0.75,indicating that the present network model has good stability.Results:(1)Characteristics of study subjects: Of the 1,301 respondents surveyed,1,239 chronic patients met the inclusion criteria and completed the assessment,with a response rate of 95.2%.The average age of the patients was 48.30±13.70 years and the average course of disease was 18.90±10.50 years.There were 750 males(60.5%)among the hospitalized SZ patients.(2)Univariate analysis results: Interpersonal relationships,social activities,smoking and alcohol consumption were factors influencing positive symptoms,negative symptoms and cognitive function in chronic SZ patients.(3)Network analysis results: The central nodes of the positive symptom,negative symptom and cognitive symptom networks were: Node P1("Delusion"),N3("Impaired emotional expression"),M8("Abstract-verbal similarity");the bridging nodes were: Node P2("Disorganized thinking"),N7("Stereotyped thinking"),N5("Abstract thinking concepts"),N6("Lack of spontaneity and fluency in conversation")and M8("Abstract-verbal similarity").The stability test of the network gave a stability coefficient of 0.75,indicating that this network model has good stability.Conclusion:(1)Patients with chronic schizophrenia have more pronounced negative symptoms and more severe impairment of cognitive function,therefore,attention should be paid to the treatment of negative symptoms and cognitive function of chronic schizophrenia.(2)"Delusions","affective communication disorder" and "abstract-word similarity" are positive symptoms,negative symptoms and cognitive function symptoms of chronic SZ patients.(3)"Conceptual disorders","stereotyped thinking","abstract thinking concepts","lack of spontaneity and fluency in conversation " and "abstract-word similarity" are bridging symptoms of positive symptoms,negative symptoms and cognitive functioning in patients with chronic SZ.These core and bridging symptoms may be closely related to the psychopathological mechanisms and treatment outcomes of chronic SZ patients,providing new ideas for targeting symptom treatment for chronic SZ patients. |
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