目的:探讨精神分裂症患者幽默体验能力及其与心理理论之间的关系。方法采用幽默图片测试( HPT)、幽默视频测试( HVT)以及心理理论故事图片任务( ToM-PST)对61名精神分裂症患者和63名正常对照者进行评估。结果 HPT 中患者组非幽默图片等级总分[(28.41±11.56)分]高于正常组[(24.41±8.82)分],幽默图片等级总分[(34.41±13.06)分]低于正常组[(45.65±11.49)分],差异有统计学意义(P<0.05);HVT中患者组幽默视频等级均分[(2.46±0.79)分]、标准幽默时刻按键次数[(2.42±1.40)次]、标准幽默时刻敏感性d’(humor)分[(0.47±0.42)分]均低于正常组[分别为(3.56±0.57)分,(3.68±1.19)次,(1.11±0.46)分, P<0.01];患者组ToM-PST总分[(39.89±12.33)分]低于正常组[(58.76±0.64)分, P<0.01]。相关分析显示,d’( humor)分与阳性与阴性症状量表( PANSS)总分( r=-0.380, P<0.01)呈负相关。患者组非幽默图片等级总分与ToM-PST总分( r=-0.316, P<0.05)呈负相关,d’( humor)分与ToM-PST总分( r=0.400, P<0.01)呈正相关。控制PANSS总分后,患者组d’( humor)分与ToM-PST总分相关性仍具有统计学意义。结论精神分裂症患者幽默体验能力较差,这种幽默体验缺陷与患者心理理论损害存在关联,提示幽默体验与心理理论之间可能存在共同的神经心理基础。
Objective To explore humor experience and its relationship with theory of mind in patients with schizophrenia. Methods sixty-one schizophrenic patients without treatment and sixty-three healthy subjects were assessed with the Humor Picture Test ( HPT) ,Humor Video Test ( HVT) and the Theory-of-Mind Picture-Se-quencing Task ( ToM-PST) . Results Compared with healthy subject in HPT,schizophrenic patients showed sig-nificantly higher non-humor picture rating score (24.41 ± 8.82 vs 28.41 ± 11.56, P〈0.05),and less humor picture rating score (45.65 ± 11.49 vs 34.41 ± 13.06, P〈0.05). Compared with healthy subject in HVT,schizophrenic patients also showed significantly less humor video rating score (3.56 ± 0.57 vs 2.46 ± 0.79, P〈0.01) and the number of standard humorous moments (3.68 ± 1.19 vs 2.42 ± 1.40, P〈0.01) and the sensitivity of standard hu-morous moments-d’(humor) score (1.11 ± 0.46 vs 0.47 ± 0.42, P〈0.01). Schizophrenic patients had significant-ly less total score (39.89 ± 12.33 vs 58.76 ± 0.64, P〈0.01) of ToM-PST compared to normal control. Correlation analysis showed a negative correlation between d’ ( humor) score and the Positive and Negative Syndrome Scale ( PANSS) total score ( r=-0.380, P〈0.01) for the patients. There was significantly negative correlation between non-humor picture rating score and ToM-PST total score ( r=-0.316, P〈0.05) ,and positive correlation between d’ (humor) score and ToM-PST total score ( r=0.400, P〈0.01) in schizophrenic patient. After controlling for the PANSS total score,the correlation between d’(humor) score and ToM-PST total score remained significant. Conclusion Schizophrenic patients have poor humor experience,which is related to the impairments of theory of mind.Humor experience deficit may share a common neuropsychological base with the impairment of theory of mind.