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Social cognition and real-life functioning in patient samples with 22q11.2 deletion syndrome with or without psychosis, compared to a large sample of patients with schizophrenia only and healthy controls 伴有或不伴有精神病的22q11.2缺失综合征患者样本的社会认知和现实生活功能,与仅患有精神分裂症的患者和健康对照的大样本相比
IF 2.2 4区 心理学 Q2 PSYCHOLOGY Pub Date : 2023-05-09 DOI: 10.1111/jnp.12322
Marianna Frascarelli, Tommaso Accinni, Antonino Buzzanca, Luca Carlone, Francesco Ghezzi, Antonella Moschillo, Georgios D. Kotzalidis, Paola Bucci, Giulia Maria Giordano, Martina Fanella, Carlo Di?Bonaventura, Carolina Putotto, Bruno Marino, Massimo Pasquini, Massimo Biondi, Fabio Di?Fabio
Patients with the 22q11.2 deletion syndrome (DS) show an increased risk of developing a psychotic illness lifetime. 22q11.2DS may represent a reliable model for studying the neurobiological underpinnings of schizophrenia. The study of social inference abilities in a genetic condition at high risk for psychosis, like 22q11.2DS, may shed light on the relationships between neurocognitive processes and patients' daily general functioning. The study sample consisted of 1736 participants, divided into four groups: 22q11.2DS patients with diagnosis of psychotic disorder (DEL SCZ, N = 20); 22q11.2DS subjects with no diagnosis of psychosis (DEL, N = 43); patients diagnosed with schizophrenia without 22q11.2DS (SCZ, N = 893); and healthy controls (HC, N = 780). Social cognition was assessed through The Awareness of Social Inference Test (TASIT) and general functioning through the Specific Levels of Functioning (SLoF) scale. We analysed data through regression analysis. The SCZ and DEL groups had similar levels of global functioning; they both had significantly lower SLoF Total scores than HC (p < .001); the DEL SCZ group showed significantly lower scores compared to the other groups (SCZ, p = .004; DEL, p = .003; HC, p < .001). A significant deficit in social cognition was observed in the three clinical groups. In the DEL SCZ and SCZ groups, TASIT scores significantly predicted global functioning (p < .05). Our findings of social cognition deficit in psychosis-prone patients point to the possible future adoption of rehabilitation programmes, like Social Skills Training and Cognitive Remediation, during premorbid stages of psychosis.
22q11.2缺失综合征(DS)患者一生中患精神疾病的风险增加。22q11.2DS可能是研究精神分裂症的神经生物学基础的可靠模型。对像22q11.2DS这样的精神病高危遗传条件下的社会推理能力的研究,可能会揭示神经认知过程与患者日常一般功能之间的关系。研究样本包括1736名参与者,分为四组:22q11.2诊断为精神障碍的ds患者(DEL SCZ, N = 20);22q11.2无精神病诊断的ds受试者(DEL, N = 43);无22q11.2DS的精神分裂症患者(SCZ, N = 893);健康对照(HC, N = 780)。通过社会推理意识测验(TASIT)评估社会认知,通过特定功能水平量表(SLoF)评估一般功能。我们通过回归分析对数据进行分析。SCZ组和DEL组的整体功能水平相似;两者的SLoF总分均显著低于HC (p < .001);DEL SCZ组得分显著低于其他组(SCZ, p = 0.004;DEL, p = .003;HC, p < .001)。在三个临床组中观察到明显的社会认知缺陷。在DEL SCZ和SCZ组中,TASIT评分显著预测整体功能(p < 0.05)。我们对精神病易发患者社会认知缺陷的研究结果表明,在精神病发病前阶段,未来可能采用康复方案,如社会技能训练和认知补救。
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引用次数: 0
Partial Klüver–Bucy syndrome in a Paediatric patient: A post-neurosurgical and neuropsychological cases 一名儿童患者的部分克吕弗-布西综合征:神经外科手术后和神经心理学病例
IF 2.2 4区 心理学 Q2 PSYCHOLOGY Pub Date : 2023-05-04 DOI: 10.1111/jnp.12320
Alejandra Estefanía Hernández-Martínez, Carlos Alberto Serrano-Juárez, Karen Grisel Barrera-Medellín, Cecilia Inés Ramírez-Quiroga, Alma Griselda Ramírez-Reyes, Roberto Casarrubias Islas, Belén Prieto-Corona

A variety of cognitive, behavioural, and emotional impairments have been reported in the literature that are associated with the resection of the temporal cortex. Klüver–Bucy syndrome is one infrequently reported disorder in the paediatric population. This paper describes the neuropsychological findings of a female paediatric patient at 7 and 10 years of age with a diagnosis of partial Klüver–Bucy syndrome (pKBS) following total resection of the amygdala and right hippocampus to resect a glioma. The patient presented emotional problems, aggressiveness, hypermetamorphosis, social indifference, and behavioural dysexecutive syndrome, which was found at both 7 and 10 years, but with a decrease in the severity of alterations in attention, impulsivity, hyperactivity, and aggressive behaviour in a second evaluation after she had a neuropsychological intervention. These findings describe the neuropsychological profile of paediatric case with resection of the amygdala and right temporal lobe.

据文献报道,与颞叶皮层切除有关的认知、行为和情感障碍有多种。克吕弗-布西综合征是一种在儿童群体中鲜有报道的疾病。本文描述了一名 7 岁和 10 岁的女性儿科患者的神经心理学研究结果,她被诊断为部分克吕弗-布西综合征(pKBS),因切除胶质瘤而对杏仁核和右侧海马进行了全切除。患者在 7 岁和 10 岁时都出现了情绪问题、攻击性、高变态、社交冷漠和行为执行障碍综合征,但在接受神经心理学干预后的第二次评估中,注意力、冲动、多动和攻击行为的改变程度有所减轻。这些研究结果描述了切除杏仁核和右颞叶的儿科病例的神经心理学特征。
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引用次数: 0
Disruption of the left anterior ventrolateral temporal cortex along with the inferior longitudinal fasciculus impairs the ability to retrieve famous face names: Evidence from three longitudinal case studies 左侧颞叶前腹外侧皮层和下纵筋膜受损会影响检索著名面孔名字的能力:三项纵向病例研究的证据
IF 2.2 4区 心理学 Q2 PSYCHOLOGY Pub Date : 2023-05-03 DOI: 10.1111/jnp.12319
Eléonor Burkhardt, Anne-Laure Lemaitre, Sam Ng, Sylvie Moritz-Gasser, Fabrice Hirsch, Hugues Duffau, Guillaume Herbet

The cortical distribution of the proper name (PN) retrieval network has been widely studied contrary to its connectional anatomy. Here, we report the case of three patients with a low-grade glioma damaging the mid-to-anterior part of the left temporal lobe. A longitudinal behavioural assessment showed that the surgery caused a long-lasting decline in PN retrieval performances in all patients. Furthermore, a detailed analysis of surgery-related structural disconnections revealed that interruption of the inferior longitudinal fasciculus was the unique common denominator.

专有名词(PN)检索网络的皮层分布与其连接解剖结构相反,已被广泛研究。在此,我们报告了三例左侧颞叶中前部低级别胶质瘤患者的病例。一项纵向行为评估显示,手术导致所有患者的PN检索能力长期下降。此外,对与手术相关的结构断裂进行的详细分析显示,下纵筋束的中断是唯一的共同点。
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引用次数: 0
A double-blind, sham-controlled, trial of home-administered rhythmic 10-Hz median nerve stimulation for the reduction of tics, and suppression of the urge-to-tic, in individuals with Tourette syndrome and chronic tic disorder 一项双盲、假对照的试验,在患有抽动症和慢性抽动障碍的个体中,家庭给予有节奏的10赫兹正中神经刺激,以减少抽动,并抑制抽动的冲动
IF 2.2 4区 心理学 Q2 PSYCHOLOGY Pub Date : 2023-05-03 DOI: 10.1111/jnp.12313
Barbara Morera Maiquez, Caitlin Smith, Katherine Dyke, Chia-Ping Chou, Belinda Kasbia, Ciara McCready, Hannah Wright, Jessica K. Jackson, Isabel Farr, Erika Badinger, Georgina M. Jackson, Stephen R. Jackson
<p>Tourette syndrome (TS) and chronic tic disorder (CTD) are neurological disorders of childhood onset characterized by the occurrence of tics; repetitive, purposeless, movements or vocalizations of short duration which can occur many times throughout a day. Currently, effective treatment for tic disorders is an area of considerable unmet clinical need. We aimed to evaluate the efficacy of a home-administered neuromodulation treatment for tics involving the delivery of rhythmic pulse trains of median nerve stimulation (MNS) delivered via a wearable ‘watch-like’ device worn at the wrist. We conducted a UK-wide parallel double-blind sham-controlled trial for the reduction of tics in individuals with tic disorder. The device was programmed to deliver rhythmic (10 Hz) trains of low-intensity (1–19 mA) electrical stimulation to the median nerve for a pre-determined duration each day, and was intended to be used by each participant in their home once each day, 5 days each week, for a period of 4 weeks. Between 18th March 2022 and 26th September 2022, 135 participants (45 per group) were initially allocated, using stratified randomization, to one of the following groups; active stimulation; sham stimulation or to a waitlist (i.e. treatment as usual) control group. Recruited participants were individuals with confirmed or suspected TS/CTD aged 12 years of age or upward with moderate to severe tics. Researchers involved in the collection or processing of measurement outcomes and assessing the outcomes, as well as participants in the active and sham groups and their legal guardians were all blind to the group allocation. The primary outcome measure used to assess the ‘offline’ or treatment effect of stimulation was the Yale Global Tic Severity Scale–Total Tic Severity Score (YGTSS–TTSS) assessed at the conclusion of 4 weeks of stimulation. The primary outcome measure used to assess the ‘online’ effects of stimulation was tic frequency, measured as the number of tics per minute (TPM) observed, based upon blind analysis of daily video recordings obtained while stimulation was delivered. The results demonstrated that after 4-week stimulation, tic severity (YGTSS-TTSS) had reduced by 7.1 points (35 percentile reduction) for the active stimulation group compared to 2.13/2.11 points for the sham stimulation and waitlist control groups. The reduction in YGTSS–TTSS for the active stimulation group was substantially larger, clinically meaningful (effect size = .5) and statistically significant (<i>p</i> = .02) compared to both the sham stimulation and waitlist control groups, which did not differ from one another (effect size = −.03). Furthermore, blind analyses of video recordings demonstrated that tic frequency (tics per minute) reduced substantially (−15.6 TPM) during active stimulation compared to sham stimulation (−7.7 TPM). This difference represents a statistically significant (<i>p</i> < .03) and clinically meaningful reduction in tic frequency (>25 p
抽动秽语综合征(TS)和慢性抽动障碍(CTD)是儿童期发病的以抽动为特征的神经系统疾病;重复的、无目的的、持续时间短的动作或声音,一天中可以发生多次。目前,抽动障碍的有效治疗是一个相当未满足临床需求的领域。我们的目的是评估家庭给药的神经调节治疗抽动症的疗效,包括通过佩戴在手腕上的可穿戴“手表状”设备传递正中神经刺激(MNS)的节律脉冲序列。我们在英国范围内进行了一项平行双盲假对照试验,以减少抽动障碍患者的抽动。该装置被编程为每天向正中神经提供有节奏的(10 Hz)低强度(1-19 mA)电刺激,持续预定的持续时间,并打算由每位参与者在家中每天使用一次,每周5天,持续4周。在2022年3月18日至2022年9月26日期间,135名参与者(每组45人)最初使用分层随机分配到以下组之一;积极的刺激;假刺激或等待名单(即正常治疗)对照组。招募的参与者是确诊或疑似TS/CTD的个体,年龄在12岁或以上,伴有中度至重度抽搐。参与测量结果收集或处理和评估结果的研究人员,以及活跃组和假组的参与者及其法定监护人都对小组分配不知情。用于评估刺激“离线”或治疗效果的主要结果测量是在4周刺激结束时评估的耶鲁全球抽动严重程度量表-总抽动严重程度评分(YGTSS-TTSS)。用于评估刺激“在线”效果的主要结果指标是抽搐频率,以观察到的每分钟抽搐次数(TPM)来衡量,该指标基于对刺激过程中获得的每日视频记录的盲目分析。结果显示,刺激4周后,主动刺激组的抽动严重程度(YGTSS-TTSS)比假刺激组和候补对照组的2.13/2.11分降低了7.1分(降低了35个百分位数)。与假刺激组和候补组相比,主动刺激组的YGTSS-TTSS降低幅度更大,具有临床意义(效应值= 0.5),统计学意义(p = 0.02),两者之间没有差异(效应值= - 0.03)。此外,视频记录的盲法分析表明,与假刺激(- 7.7 TPM)相比,主动刺激期间抽搐频率(每分钟抽搐次数)大幅降低(- 15.6 TPM)。这一差异具有统计学意义(p < .03),并且具有临床意义的抽动频率降低(p < .03)。这些发现表明,通过可穿戴式腕带设备进行家庭节律性MNS治疗有可能成为一种有效的社区抽动障碍治疗方法。
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引用次数: 0
Chronic pain relief after receiving affective touch: A single case report 接受情感触摸后慢性疼痛缓解:1例报告
IF 2.2 4区 心理学 Q2 PSYCHOLOGY Pub Date : 2023-04-28 DOI: 10.1111/jnp.12321
Larissa L. Meijer, Carla Ruis, Maarten J. van der Smagt, H. Chris Dijkerman

Affective touch is gentle slow stroking of the skin, which can reduce experimentally induced pain. Our participant, suffering from Parkinson's Disease and chronic pain, received 1 week of non-affective touch and 1 week of affective touch as part of a larger study. Interestingly, after 2 days of receiving affective touch, the participant started to feel less pain. After 7 days, the burning painful sensations fully disappeared. This suggest that affective touch may reduce chronic pain in clinical populations.

情感触摸是对皮肤的轻柔缓慢的抚摸,可以减少实验中引起的疼痛。我们的参与者患有帕金森病和慢性疼痛,作为一个更大的研究的一部分,他们接受了一周的非情感触摸和一周的情感触摸。有趣的是,在接受情感触摸两天后,参与者开始感到更少的疼痛。7天后,灼痛感完全消失。这表明情感触摸可以减轻临床人群的慢性疼痛。
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引用次数: 2
Oxford cognitive screen: A critical review and independent psychometric evaluation 牛津认知屏幕:一个批判性的审查和独立的心理测量评估
IF 2.2 4区 心理学 Q2 PSYCHOLOGY Pub Date : 2023-04-26 DOI: 10.1111/jnp.12318
Donnchadh Murphy, Emily Cornford, Alice Higginson, Alyson Norman, Rebecca Long, Rupert Noad

The Oxford cognitive screen (OCS) is a stroke-specific cognitive screening assessment. Although the test developers have provided psychometric information for the assessment, the OCS has received minimal external scrutiny, with which to triangulate the underpinning psychometrics. The purpose of this study is to provide a critical review and independent validation of the OCS. This study analysed data from an anonymised clinical database, which consisted of 316 patients who were assessed using the OCS on an Acute Stroke Unit. The rates of impairment on tests of memory and receptive communication were lower than expectation, suggesting that these subtests may be relatively insensitive. Patients with aphasia were more likely to be unable to categorised as impaired on non-language tests, suggesting that they remain sensitive to language processing or non-dominant hand usage. Some of the subtests of the OCS achieve high retest reliability, which makes them good candidates for measuring cognitive change over time. Although the OCS has many advantages, it is also important to adequately consider its limitations, that is insensitivity to memory problems, the potential confounding impact of non-dominant hand usage, and the potential that some tests may sample overall cognitive ability instead of domain-specific functioning.

牛津认知筛查(OCS)是一种针对中风的认知筛查评估。尽管测试开发者为评估提供了心理测量信息,但OCS只接受了很少的外部审查,从而无法对基础心理测量进行三角测量。本研究的目的是对OCS进行批判性审查和独立验证。本研究分析了来自匿名临床数据库的数据,该数据库由316名患者组成,这些患者在急性卒中单元使用OCS进行评估。记忆和接受性沟通测试的损伤率低于预期,表明这些子测试可能相对不敏感。失语症患者更有可能无法在非语言测试中被归类为受损,这表明他们对语言处理或非惯用手的使用仍然敏感。OCS的一些子测试达到了很高的重测信度,这使它们成为衡量随时间变化的认知变化的良好候选者。尽管OCS有许多优点,但充分考虑其局限性也很重要,如对记忆问题不敏感,非惯用手使用的潜在混淆影响,以及一些测试可能抽样整体认知能力而不是特定领域功能的潜力。
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引用次数: 0
Prospective memory in early and established psychosis: An Indian perspective 前瞻性记忆在早期和建立精神病:一个印度的观点
IF 2.2 4区 心理学 Q2 PSYCHOLOGY Pub Date : 2023-04-18 DOI: 10.1111/jnp.12314
Pulijala Sulakshana Rao, Madhavi Rangaswamy, Jonathan Evans, Anirban Dutt

Individuals affected by psychosis often have deficits in several neurocognitive functions. Prospective memory (PM), the ability to remember to do things, is crucial for activities of daily living, social and occupational functioning, but very few studies have attempted to examine this domain of functioning in people with psychosis, particularly in India. A total of 71 patients with psychosis, (both early and established psychosis), and 140 age, gender and education-matched healthy controls were assessed using the Positive and Negative Symptom Scale, Hospital Anxiety and Depression scale, and Addenbrooke's Cognitive Examination. PM was assessed using the Cambridge Prospective Memory Test and the Prospective and Retrospective Memory Questionnaire (PRMQ). Group differences were evaluated using Mann–Whitney U-tests. Significantly greater cognitive deficits, higher anxiety and depression were evident in the psychosis group compared with controls. The psychosis group performed significantly poorer on both time- and event-based tests in CAMPROMPT than controls. These differences remained when controlling for age, education, general cognitive functioning and mood. The subjective measure of PM (PRMQ) did not differentiate the two groups. The PM performance of early and established psychosis patients was similar. Comparisons with cross-cultural data (PRMQ UK norms and CAMPROMPT and PRMQ Chinese data) revealed important differences in PM performance. Individuals with psychosis have significant deficits in both time- and event-based PM. CAMPROMPT emerged as a more sensitive PM measure compared with PRMQ. Results from cross-cultural comparisons underscore the need for cultural contextualization of assessments.

受精神病影响的个体通常有几种神经认知功能的缺陷。前瞻记忆(PM),即记住做事的能力,对日常生活活动、社会和职业功能至关重要,但很少有研究试图检查精神病患者的这一功能领域,尤其是在印度。采用阳性和阴性症状量表、医院焦虑和抑郁量表和阿登布鲁克认知检查对71名精神病患者(包括早期和确诊精神病)和140名年龄、性别和教育程度相匹配的健康对照进行评估。采用剑桥前瞻记忆测验和前瞻与回顾性记忆问卷(PRMQ)对PM进行评估。采用Mann-Whitney u检验评估组间差异。与对照组相比,精神病组明显有更大的认知缺陷、更高的焦虑和抑郁。精神病组在CAMPROMPT的时间和基于事件的测试中都比对照组表现明显差。在控制了年龄、教育程度、一般认知功能和情绪等因素后,这些差异仍然存在。主观测量PM (PRMQ)没有区分两组。早期和确诊精神病患者的PM表现相似。与跨文化数据(PRMQ英国规范和CAMPROMPT和PRMQ中国数据)的比较揭示了PM绩效的重要差异。精神病患者在基于时间和事件的PM方面都有明显的缺陷。CAMPROMPT是一种比PRMQ更敏感的PM测量方法。跨文化比较的结果强调了评估的文化背景化的必要性。
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引用次数: 0
Full-field input generated from right visual field information for healthy participants reproduces performance simulating left unilateral spatial neglect in line bisection 健康受试者从右侧视野信息产生的全视野输入再现了在线平分中模拟左单侧空间忽视的表现
IF 2.2 4区 心理学 Q2 PSYCHOLOGY Pub Date : 2023-04-17 DOI: 10.1111/jnp.12316
Keita Nukui, Sumio Ishiai

Patients with left unilateral spatial neglect (USN) typically place the subjective midpoint to the right of the objective centre when bisecting a horizontal line. This pathological phenomenon may be explained as a result of greater dependence on the right endpoint in the external reference frame (Koyama et al., Brain Cogn, 35, 1997, 271; McIntosh et al., Cogn Brain Res, 25, 2005, 833). Ishiai et al. (Brain, 112, 1989, 1485) reported that once patients with USN fixated on a certain point on the right part of the presented line, they persisted with this point and marked the subjective midpoint there without leftward searches. Ishiai et al.'s interpretation was that the patients saw a totalised line representation that extended equidistantly to the right and left sides, based on the information of the attended rightward extent from the subjective midpoint. Accordingly, we used virtual reality goggles (VRG) and devised a mirror-image viewing (MV) condition that showed a full-field view based on the right visual field information to test whether healthy participants would thereby show neglect-like bisection performance. The participants were 30 healthy adults (22–37 years old; 15 women and 15 men). In this condition, 96.7% (29/30) of participants were judged to exhibit USN-like performance of line bisection, indicating the effectiveness of MV condition to simulate USN. The novelty of the present study lies in the use of a task-specific intervention of neglect-like visuospatial processing during line bisection without attempting to modify the direction of spatial attention. This approach may contribute to the understanding of the pathological visuospatial processing of USN.

左侧单侧空间忽视(USN)患者在平分水平线时,通常将主观中点置于客观中心的右侧。这种病理现象可以解释为对外部参考框架中右终点的更大依赖(Koyama等人,Brain Cogn, 35,1997,271;McIntosh et al.,脑科学学报,2005,33(3)。Ishiai等人(Brain, 11,1989,1485)报道,一旦USN患者盯着呈现线右侧的某一点,他们就会一直盯着这个点,并在那里标记主观中点,而不会向左搜索。Ishiai等人的解释是,根据主观中点向右延伸的信息,患者看到了一个向左右两边等距延伸的总线表征。因此,我们使用虚拟现实护目镜(VRG)并设计了一个镜像观看(MV)条件,该条件显示了基于正确视野信息的全景视图,以测试健康参与者是否会因此表现出类似忽略的对分性能。参与者为30名健康成人(22-37岁;15名女性和15名男性)。在此条件下,96.7%(29/30)的参与者被判断为具有类似USN的线平分性能,表明MV条件模拟USN的有效性。本研究的新颖之处在于,在不试图改变空间注意方向的情况下,在切线过程中使用了一种特定任务的忽视样视觉空间加工干预。这种方法可能有助于理解USN的病理视觉空间加工。
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引用次数: 0
Exploring mechanisms that affect retrograde memory for public events in amnestic mild cognitive impairment: A longitudinal update 探索影响遗忘性轻度认知障碍患者对公共事件逆行记忆的机制:一项纵向更新
IF 2.2 4区 心理学 Q2 PSYCHOLOGY Pub Date : 2023-04-17 DOI: 10.1111/jnp.12317
Maria Stefania De Simone, Marta Rodini, Massimo De Tollis, Carlo Caltagirone, Giovanni Augusto Carlesimo

Here, we examined mechanisms that affect retrograde memory in amnestic mild cognitive impairment (a-MCI) as a function of longitudinal clinical outcome. 8 a-MCI who converted to Alzheimer's dementia (AD) during the subsequent 3-year follow-up (converter a-MCI) and 10 a-MCI who remained clinically stable during the same period (stable a-MCI) were compared at the baseline evaluation (i.e., when they were diagnosed as a-MCI) using a remote memory questionnaire for public events that allows disentangling the differential contribution of storage and retrieval mechanisms to performance accuracy. Results suggest that deficits in remote memory are primarily explained by impaired retrieval abilities in stable a-MCI and by impaired storage in converter-to-AD a-MCI. This distinction between retrograde amnesia due to defective trace utilisation in stable a-MCI and trace storage in converter a-MCI is consistent with the temporal unfolding of declining anterograde memory over the course of disease progression to AD.

在这里,我们研究了影响健忘性轻度认知障碍(a- mci)逆行记忆的机制,作为纵向临床结果的函数。在随后的3年随访中,8名转换为阿尔茨海默氏痴呆(AD)的a- mci(转换型a- mci)和10名在同一时期临床保持稳定的a- mci(稳定型a- mci)在基线评估时(即当他们被诊断为a- mci时)进行比较,使用公共事件远程记忆问卷,可以理清存储和检索机制对表现准确性的差异贡献。结果表明,远程记忆缺陷主要由稳定型a-MCI的检索能力受损和转换型- ad型a-MCI的存储能力受损来解释。稳定型a-MCI中由于痕量利用缺陷而导致的逆行性遗忘与转换型a-MCI中由于痕量存储缺陷而导致的逆行性遗忘之间的区别,与在疾病进展为AD的过程中逆行性记忆下降的时间展开是一致的。
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引用次数: 1
What helps patients to prepare for and cope during awake craniotomy? A prospective qualitative study 在清醒开颅手术中,什么能帮助患者做好准备并应对手术?一项前瞻性定性研究。
IF 2.2 4区 心理学 Q2 PSYCHOLOGY Pub Date : 2023-04-10 DOI: 10.1111/jnp.12311
Aleksandra Bala, Agnieszka Olejnik, Tomasz Dziedzic, Jolanta Piwowarska, Anna Podgórska, Andrzej Marchel

There is growing interest in awake craniotomies, but some clinicians are concerned that such procedures are poorly tolerated by patients. Therefore, we conducted a study to assess this phenomenon. In this prospective qualitative study, 68 patients who qualified for awake craniotomy were asked to complete the Hospital Anxiety and Depression Scale (HADS)—two days before the surgery and visual analogue scales (VAS) for pain and stress, two days before the surgery and again about two days after. In addition, after their surgery, they took part in a structured interview about what helped them prepare for and cope with the surgery. Most patients tolerated the awake surgery well, scoring low on stress and pain scales. They reported a lower level of stress during the surgery (when questioned afterwards) than before it. Intensity of stress before the surgery correlated negatively with age, positively with HADS anxiety score and positively with stress subsequently experienced during surgery. The level of stress during surgery was associated with stress experienced before the surgery, pain and HADS anxiety and depression scores. Severity of pain during the surgery was positively correlated with stress during surgery and HADS depression and anxiety scores before the surgery. There was no correlation between stress, pain, anxiety and depression and the location of the lesion. Patients have a high tolerance for awake craniotomy. Various factors have an impact on how well patients cope with the operation. Extensive preoperative preparation should be considered a key part of the procedure.

人们对清醒开颅手术的兴趣与日俱增,但一些临床医生担心患者对此类手术的耐受性较差。因此,我们开展了一项研究来评估这一现象。在这项前瞻性定性研究中,我们要求 68 名符合清醒开颅手术条件的患者在手术前两天填写医院焦虑抑郁量表(HADS),并在手术前两天和手术后两天填写疼痛和压力视觉模拟量表(VAS)。此外,在手术后,他们还参加了一次结构化访谈,了解是什么帮助他们准备和应对手术。大多数患者对清醒手术的耐受性良好,在压力和疼痛量表中得分较低。与手术前相比,他们在手术过程中(术后接受询问时)的压力水平较低。手术前的压力强度与年龄呈负相关,与HADS焦虑评分呈正相关,与手术中的压力呈正相关。手术中的压力水平与手术前的压力、疼痛以及 HADS 焦虑和抑郁评分相关。手术中疼痛的严重程度与手术中的压力以及手术前的 HADS 抑郁和焦虑评分呈正相关。压力、疼痛、焦虑和抑郁与病变位置之间没有相关性。患者对清醒开颅手术的耐受性很高。患者对手术的耐受程度受多种因素影响。广泛的术前准备应被视为手术的关键部分。
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Journal of Neuropsychology
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