| Summary: | 碩士 === 高雄醫學大學 === 心理學研究所 === 98 === Background: For the course of schizophrenia tending to be chronic, patients with schizophrenia in Taiwan utilized a disproportionately high amount of health care services and reduced the productivity of the caregiver, which consumes enormous economic costs. One of the core symptoms of schizophrenia is diminishing executive function. Previous studies have found that impairment in executive function is associated with the inability to take care of themselves and live independently. Objective: This study intends to understand the impaired components of executive function among chronic schizophrenia and its association with daily living ability. Method: 48 patients with a diagnosis of schizophrenia according to DSM-IV-TR (28 men and 20 women, mean age 37.59) were recruited from outpatient services and day care center. Additionally, they must fulfill the definition of “chronic” in this study, meaning that “the patient’s course of illness is stabilized and is at least 10 years from onset. Their onset must be prior to 25 years old, respectively, and they have been on continuous medication in the past one year. Materials used includes: Brief Psychiatric Rating Scale (BSRS) for symptom severity; Wechsler Adult Intelligence Scale (Chinese version) - Third Edition for intelligence; Wisconsin Card Sorting Test (WCST), Stroop test, Tower of London (TOL), Trial Making Test (TMT), Verbal Memory Test and Digit Span Task for testing executive function; Personal and Social Performance Scale (PSP) and Hierarchy of the Care Required (HCR) for testing daily living ability. The executive function, tested by executive tasks, is comprised of 6 components: (1) motor initiation and efficiency, (2) cognitive fluency, (3) self-monitoring efficiency, (4) planning, (5) response inhibition and compulsion control, and (6) working memory. Stepwise regression was used to explore demography, medical history of schizophrenia, components of executive function associated with daily living ability. Results: Compared with normal individual in the previous study, participants in this study generally were worse on executive tasks. Furthermore, they also showed poor performances in daily living ability. Their cognitive fluency, working memory, self-monitoring efficiency correlated with personal and social performance, instrumental activity of daily living, cognitive and emotional function in turn. Beyond these, patient’s performance in instrumental activity of daily living also correlated with cognitive fluency and motor initiation and efficiency. Discussion: The chronic schizophrenia patient’s performances in different daily living abilities are associated with different components of executive function. This result suggests the need to choose adequate assessment tasks and cognitive rehabilitation program for specific daily living inability.
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