Correlation Between Alexithymia And Depressive Symptoms And Cognitive Ability In First Episode Schizophrenics

Objective Schizophrenic patients often show abnormalities in cognition,thinking,emotion and behavior,including positive symptoms dominated by hallucinations,delusions,thinking disorders and abnormal behavior,and negative symptoms dominated by poor thinking,lack of will and apathy.It is a chronic prolonged severe mental disorder with high disability rate and serious social burden.At present,the etiology is not clear,clinical diagnosis is usually based on symptomatology.Patients often have cognitive impairment such as impaired attention and slow response,which will further lead to the impairment of patients’ social function,such as incompetence and social withdrawal,which will lead to depression symptoms such as lack of pleasure and lack of interest.It is one of the most disabling diseases in the world.Lifetime prevalence of schizophrenia worldwide is about 1%.According to the 2016 global disease burden study,schizophrenia ranks 12 th among disabling diseases.Epidemiological survey shows that the number of schizophrenic patients has increased to 20.9 million in 2016.The negative symptoms of schizophrenia seriously affect the social function of patients,which is the difficulty of clinical treatment.Affective disorder is one of its main manifestations,includes three aspects,difficulty in e motion recognition,emotion experience and expression,while alexithymia includes three aspects,inability to describe emotion,inability to distinguish emotion and extroverted thinking.It refers to the difficulty of recognizing and experiencing one’s own emotions.Studies have shown that the higher the degree of alexithymia,the more likely patients are to adopt depressive coping styles.At the same time,it is more likely to be accompanied by low self-esteem and negative automatic thinking,which is closely related to the impairment of patients’ social function.It is difficult to promote the complete recovery of schizophrenia by antipsychotic,but it is very important to evaluate whether patients recover.A number of studies have shown that the degree of alexithymia in schizophrenic patients is significantly higher than that in normal subjects,and their ability to describe and distinguish their own emotions and extroverted thinking are lower than that in normal subjects.Some studies also believe that alexithymia may be an important predictor of comprehensive social function recovery in patients with schizophrenia.However,few studies have evaluated the correlation between cognitive impairment,self-esteem,alexithymia and depressive symptoms in patients with schizophrenia.Therefore,the purpose of this study is to study the correlation between alexithymia and depressive symptoms and cognitive impairment in schizophrenic patients,so as to provide theoretical support for targeted psychological intervention in schizophrenic patients,help patients restore social function and reduce the economic burden of patients’ families and society.Method In this study,107 patients with first-episode schizophrenia in the closed ward of Hefei Fourth People’s hospital were included as the case group,and 45 healthy subjects were selected as the normal control group,during hospitalization,the patient group was asked to complete general demographic data,Toronto alexithymia scale-20（TAS-20）,Montreal cognitive assessment scale（Mo CA）,Self-esteem scale（SES）,and Chinese version of stigma scale for mental illness（SSMI-C）,positive and negative syndrome scale（PANSS）.In the same environment,45 healthy subjects completed general demographic data,Toronto Alexithymia scale-20（TAS-20）,Montreal cognitive assessment scale（Mo CA）and self-esteem scale（SES）under the guidance of two trained psychiatrists.After two psychiatrists’ statistical scales and data entry,the data was analyzed through spss22.0 software.Results In the general information questionnaire,there was no significant difference in age,gender,years of education,marriage and occupation between the first-episode schizophrenic group and the normal control group（P>0.05）.The emotional ability and cognitive function of the patient group were significantly impaired（P<0.05）.The score of SES scale in the first-episode schizophrenia group was higher than that in the normal control group,and the difference was statistically significant（P<0.05）.In the firstepisode schizophrenic group,F1 in TAS-20 was negatively correlated with visual space and executive function,delayed recall and Mo CA total score.F2（inability to describe emotion）in TAS-20 was positively correlated with F5（depression）in PANSS,it was negatively correlated with visual space and executive function,delayed recall and orientation in Mo CA,negatively correlated with the total score of Mo CA,positively correlated with F3（extraversion thinking）in TAS-20 and F5（depression）and F6（supplementary aggression）in PANSS,and negatively correlated with visual space and executive function,name and total score of Mo CA,the total score of SES was positively correlated with F5（depression）in PANSS.F1（discrimination）in SSMI-C was positively correlated with delayed recall in Mo CA（P< 0.05）.Stepwise regression analysis was conducted on sociodemographic characteristics,cognitive function,psychiatric symptoms and self-esteem to predict the risk factors of alexithymia.PANSS depression subscale was positively correlated with emotional description difficulty（β= 0.188,t =-2.007,P = 0.047）,showing a negative correlation with the score of externally oriented thinking subscale（β=-0.244,t=-2.603,P=0.011）.Conclusion Compared with the normal control group,the first-episode schizophrenic patients scored significantly higher in the three dimensions of alexithymia: emotion recognition inability,description inability and extroverted thinking than the normal control group.In terms of cognitive function,the overall impairment of cognitive function in schizophrenic patients was more serious than that in healthy group.Interestingly,the self-esteem level of patients with first-episode schizophrenia was higher than that of the healthy group.We found that the depressive symptoms and self-esteem of patients with first-episode schizophrenia were positively correlated with alexithymia,while their cognitive function was negatively correlated with alexithymia.In addition,we also found that the levels of cognitive impairment,alexithymia and self-esteem may be highly specific,and may be one of the sensitive risk predictors of the severity of depressive symptoms in patients with first-episode schizophrenia.