psychiatryПСИХИАТРИЯPsychiatry (Moscow) (Psikhiatriya)1683-83192618-6667FSBSI “The Mental Health Research Centre”; LLC «Publisher «MIA»10.30629/2618-6667-2022-20-4-74-83psychiatry-889Research ArticleПСИХОПАТОЛОГИЯ, КЛИНИЧЕСКАЯ И БИОЛОГИЧЕСКАЯ ПСИХИАТРИЯPSYCHOPATHOLOGY, CLINICAL AND BIOLOGICAL PSYCHIATRYВыделение когнитивных подтипов шизофрении (с оценкой перцептивных нарушений). Пилотное исследованиеDetection of Cognitive Subtypes of Schizophrenia (with Assessment of Perceptual Disorders). A Pilot Studyhttps://orcid.org/0000-0002-5311-8438КарпинскаяВ. Ю.KarpinskaiaV. Yu.

Карпинская Валерия Юльевна - доктор психологических наук.

Санкт-Петербург

Valeria Yu. Karpinskaia - Dr. of Sci. (Psychol.), St. Petersburg State University.

St. Petersburg

karpinskaya78@mail.ruhttps://orcid.org/0000-0002-3418-8596ТумоваМ. А.TumovaM. A.

Тумова Марианна Анатольевна.

Санкт-Петербург

Marianna A. Tumova.

St. Petersburg

marianna_tumova@mail.ruhttps://orcid.org/0000-0001-5948-0991ЛяховецкийВ. А.LyakhovetskyV. A.

Ляховецкий Всеволод Александрович - кандидат технических наук.

Санкт-Петербург

Vsevolod A. Lyakhovetsky - Candidate of Technical Sciences, St. Petersburg State University.

St. Petersburg

v_la2002@mail.ruhttps://orcid.org/0000-0001-5851-0626СтановаяВ. В.StanovayaV. V.

Становая Виктория Владимировна.

Санкт-Петербург

Victoria V. Stanovaya.

St. Petersburg

vika06.95@mail.ruhttps://orcid.org/0000-0001-7829-2486ИвановМ. В.IvanovM. V.

Иванов Михаил Владимирович - доктор медицинских наук, профессор.

Санкт-Петербург

Mikhail V. Ivanov - Dr. of Sci. (Med.), Professor, Bekhterev National Medical Research Center for Psychiatry and Neurology.

St. Petersburg

profmikhailivanov@gmail.comСанкт-Петербургский государственный университетРоссияSt. Petersburg State UniversityRussian FederationСанкт-Петербургский государственный университет; Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. Бехтерева Министерства здравоохранения Российской ФедерацииРоссияSt. Petersburg State University; V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology Ministry of Health of the Russian FederationRussian FederationНациональный медицинский исследовательский центр психиатрии и неврологии имени В.М. Бехтерева Министерства здравоохранения Российской ФедерацииРоссияV.M. Bekhterev National Medical Research Center for Psychiatry and Neurology Ministry of Health of the Russian FederationRussian Federation2022110120232047483Copyright © Карпинская В.Ю., Тумова М.А., Ляховецкий В.А., Становая В.В., Иванов М.В., 20232023Карпинская В.Ю., Тумова М.А., Ляховецкий В.А., Становая В.В., Иванов М.В.Karpinskaia V.Y., Tumova M.A., Lyakhovetsky V.A., Stanovaya V.V., Ivanov M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.journalpsychiatry.com/jour/article/view/889

Обоснование: гетерогенность шизофрении препятствует усилиям по обеспечению адекватного лечения. Одним из шагов к оптимизации лечения является углубление понимания разнообразия когнитивных нарушений при этом заболевании. Быть может, вследствие этой неоднородности, несмотря на то что нарушения зрительного восприятия оказываются частым симптомом шизофрении, многие исследования демонстрируют противоречивые данные. Целью нашего исследования было выделение однородных групп пациентов с шизофренией на основе восприимчивости к иллюзии Понцо, выраженности когнитивных нарушений (BACS T-score) и тяжести психического состояния в процессе терапии (общий балл по шкале PANSS), а также изучение связи между клиническими показателями и величиной иллюзии. Пациенты и методы: в проспективное шестинедельное обсервационное исследование были включены 30 пациентов с параноидной формой шизофрении на второй неделе стабильной антипсихотической монотерапии, 11 из которых выбыли в связи с наличием критериев исключения. На второй и восьмой неделе терапии у пациентов оценивали восприимчивость к иллюзии Понцо, когнитивные нарушения с помощью батареи тестов BACS и тяжесть психического состояния с использованием шкалы PANSS. Результаты: с помощью кластерного анализа были выделены два кластера пациентов, которые различались по выраженности когнитивно-перцептивных нарушений. Пациенты первого кластера (n = 9) со значимо более высоким баллом по негативным симптомам PANSS и выраженными когнитивными нарушениями на второй и восьмой неделе терапии были склонны к переоценке иллюзии Понцо, в то время как у пациентов второго кластера (n = 10) восприимчивость к иллюзии Понцо была ниже. Выводы: проведенное исследование позволило выделить два кластера пациентов, отличающихся по тяжести когнитивных и зрительных нарушений; была продемонстрирована связь восприимчивости к иллюзии Понцо с такими клиническими показателями, как негативные и когнитивные симптомы, что подтверждает информативность использования методологии зрительных иллюзий в качестве маркера психического состояния.

Background: the heterogeneity of schizophrenia impedes our efforts to provide adequate treatment. One step toward optimizing treatment is to deepen our understanding of cognitive variety in this disorder. Perhaps due to this heterogeneity, although visual impairment is a frequent symptom of schizophrenia, many studies show inconsistent data. The aim of our study was to identify homogeneous groups of patients with schizophrenia based on susceptibility to the Ponzo illusion, cognitive impairment degree (BACS T-score) and severity of mental state during therapy (Total PANSS score) and to examine the relationship between clinical parameters and the value of the illusion. Patients and methods: a prospective six-week observational study included 30 patients with the paranoid form of schizophrenia in the second week of stable antipsychotic monotherapy, 11 of whom dropped out due to exclusion criteria. At the second and eighth weeks of treatment, patients were assessed for susceptibility to the Ponzo illusion, cognitive impairment using a battery of BACS tests, and severity of mental status during a semi-structured interview using the PANSS scale. Results: the cluster analysis identified 2 clusters of patients who differed in their susceptibility to the Ponzo illusion. Patients in the first cluster (n = 9) with a significantly higher score on negative PANSS symptoms and marked cognitive impairment in the second and eighth weeks of therapy were prone to overestimate the Ponzo illusion, while patients in the second cluster (n = 10) were less susceptible to the Ponzo illusion. Conclusions: this study allowed us to identify two clusters of patients differing in the severity of cognitive and visual impairments, the relationship of susceptibility to Ponzo illusion with such clinical indicators as negative and cognitive symptoms was demonstrated, which confirms the informative value of using the visual illusion methodology as a marker of mental state.

шизофрениякогнитивные функциииллюзия ПонцоBACS (Brief Assessment of Cognition in Schizophrenia)PANSS (Positive and Negative Syndrome Scale)schizophreniacognitive functionsPonzo's illusionBACS (Brief Assessment of Cognition in Schizophrenia)PANSS (Positive and Negative Syndrome Scale)Работа выполнена при финансовой поддержке гранта РНФ (проект № 22-18-00074) «Психологические механизмы рассогласования восприятия и действия при решении задач в условиях зрительных иллюзий».This work was supported by a grant from the Russian Science Foundation (project No. 22-18-OO074) “Psychological mechanisms of perception and action mismatch when solving tasks under visual illusions”.ReferencesKeefe RSE, Eesley CE, Poe MP. Defining a cognitive function decrement in schizophrenia. Biol Psychiatry. 2005;57(6):688-691. doi: 10.1016/j.bio-psych.2005.01.003Keefe RSE, Eesley CE, Poe MP. Defining a cognitive function decrement in schizophrenia. 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The authors declare that there are no conflicts of interest present.