Cross-diagnosis Comparison Of Two Types Of Social Psychological Stress Factors Between First-episode Schizophrenia And Depression And Its Relationship With Cognitive Impairment

Objective:This study evaluated the cognitive function level and childhood trauma(physical abuse,emotional abuse,sexual abuse,physical neglect,emotional neglect),recent negative life events and clinical symptoms,to explore the correlation between childhood trauma and recent negative life events,two types of social psychological stress factors,and the onset,cognitive dysfunction and clinical symptoms of patients with the first-episode schizophrenia and the first episode of depression.Methods:Screening patients with the first-episode schizophrenia and the first episode of depression that meets the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorder 4th Edition(DSM-?).This study included a total of 149 patients in the psychiatric outpatient and inpatient department of the First Affiliated Hospital of Kunming Medical University from November 2018 to March 2020,including 56 patients with the first-episode schizophrenia and 93 patients with the first episode of depression.At the time of enrollment,the general clinical data of the patients were collected,and the Hamilton Depression Scale(HAMD-17),Hamilton Anxiety Scale(HAMA),Positive and Negative Symptoms Scale(PANSS),Social Function Defect Screening Scale(SDSS),cognitive function level test,childhood trauma questionnaire CTQ)and Life Events Scale were accomplished.SPSS 20.0 software was used for statistical analysis,general statistical data and scale score data were used for descriptive statistical analysis,one-way analysis of variance was used for comparison of measurement data between three groups,and independent sample T test was used for comparison of samples between two groups.disobeying Rank distribution test was used for normal distribution data;Pearson correlation analysis was used for comparison of continuous data,Spearman correlation analysis was used for comparison of discontinuous data within the group;P<0.05 indicated that the difference was statistically significant.Results:1.In a comparison of the cognitive function suite(MCCB).except for the mood management subtest,there was no significant difference between the two groups,P>0.05;In other MCCB subtests,there were significant differences in the cognitive function levels of patients with the first-episode schizophrenia and the first episode of depression,P<0.05;2.Childhood traumatic experiences were compared between the first-episode schizophrenia the first episode of depression group and the normal control group,physical abuse,emotional abuse,sexual abuse,physical and emotional neglect and the total scores of childhood trauma were significantly different from those of the normal control group,All dimension scores of the patient group were higher than that of the normal control group,P<0.05.Social environmental stress factors are related to the onset of schizophrenia and depression.There was a significant difference between the emotional abuse(EA)score of the first episode of depression patient group and the first-episode schizophrenia patient group in the childhood trauma score test,P<0.05;Childhood physical abuse,emotional abuse,sexual abuse,physical and emotional neglect and the total scores of childhood trauma has no significant difference between patients with the first-episode schizophrenia and the first episode of depression,P>0.05;3.The degree of cognitive impairment was more severe in patients with the first-episode schizophrenia and the first episode of depression with social environmental stress than in patients without social environmental stressfactors.P<0.05;4.There was a negative correlation between childhood emotional abuse and movement fluency(r=-0.370,P=0.005)and Stroop color(r=-0.291,P=0.030)in the cognitive function subtest of patients with the first-episode schizophrenia,but no correlation was found between recent negative events and cognitive function test of patients with the first-episode schizophrenia,P>0.05;Recent negative life events were negatively correlated with sign coding(r=-0.244,P=0.018),animal fluency(r=-0.263,P=0.011),Stroop words(R=-0.221,P=0.033)and Stroop color words(r=-0.225,P=0.030)in cognitive function subtest of patients with the first episode of depression.Childhood emotional neglect was negatively correlated with Spatial memory(r=-0.242,P=0.019),Stroop word(R=-0.212,P=0.041),Stroop color(R=-0.207;P=0.047),Stroop color word(r=-0.242,P=0.019)in cognitive function subtest of patients with the first episode of depression;5.There is no significant correlation between childhood trauma and various dimensions score,and recent negative life events,two types of social psychological stress factors,and depression and anxiety symptoms in patients with the first episode of depression,and the total score of positive and negative symptoms in patients with the first-episode schizophrenia,P>0.05.There is a negative correlation between childhood sexual abuse and positive symptoms(r=-0.312,P=0.019).There is a negative correlation between recent negative life events and negative symptoms(r=-0.288,P=0.031),and there was a negative correlation between childhood emotional neglect and general psychotic symptoms(r=-0.310,P=0.020).Conclusion(s):1.The patients with the first-episode schizophrenia and the first episode of depression were significantly higher than the control group in all dimensions of childhood trauma.Compared with the group of patients with the first-episode schizophrenia,the occurrence and development of the first episode of depression were more closely related to childhood emotional abuse and recent negative life events;2.The cognitive deficits of patients with the first-episode schizophrenia and the first episode of depression with social environmental stress factors are more severe than those without social environmental stress factors.Social environmental stress factors may induce the occurrence and development of diseases through the impairment of cognitive function;3.Cognitive deficits is common in the early stage of schizophrenia and depression;Compared with patients with the first episode of depression,patients with the first-episode schizophrenia have more serious cognitive impairment,it is speculated that the severity of cognitive impairment may be an important indicator for the differential diagnosis and prognosis of schizophrenia and depression.4.There is a correlation between childhood trauma and cognitive deficits in patients with the first-episode schizophrenia and the first episode of depression;there is a correlation between recent negative life events and cognitive deficits in patients with the first episode of depression,but no correlation with cognitive deficits in patients with the first-episode schizophrenia;early environmental stress factors may be related to the occurrence and development of schizophrenia;5.There is no correlation between childhood trauma and negative life events,two types of social psychological stress factors,and depression and anxiety symptoms in patients with the first episode of depression,and the total score of positive and negative symptoms in patients with the first-episode schizophrenia.There is a correlation between childhood sexual abuse and positive symptoms of patients with the first-episode schizophrenia.There is a correlation between recent negative life events and negative symptoms,and there was a correlation between childhood emotional neglect and general psychotic symptoms.