描画にみられる統合失調症患者における認知機能障害—他者の視点をイメージすることに注目して

The Cognitive Impairment from Drawing on Patients with Schizophrenia: Focusing on the image of the other person's perspective

抄録

　統合失調症入院患者41名に，3つの立方体を患者側からの視点（0度描画）と研究者側からの視点（180度描画）から描かせるとともにS-HTP（Synthetic House-Tree-Person Technique；統合型HTP法）を施行し，認知機能障害のどの段階で困難さを示すか検討した。さらにWAIS-Ⅲ（簡易実施法）とBPRSの得点，投薬量，罹患・入院期間と，各描画の構成・統合度との関連性についても検討した。その結果，0度描画に失敗した患者は，S-HTPの家・木・人を統合的に描けず180度描画にも失敗し，0度描画，S-HTP，180度描画の順に難易度が上がることが示された。0度描画とS-HTPは主に推理能力と，180度描画は知能全般と関係した。3種類の描画を施行することにより，統合失調症患者の認知機能レベルが測れる可能性が示唆された。

　By having 41 inpatients with schizophrenia draw three-dimensional shapes from their own viewpoint (0-angle drawing), from an observer's viewpoint (180-angle drawing), and take the Synthetic House-Tree-Person test (S-HTP), we clarified at which stage of cognitive function patients with schizophrenia have difficulty doing these tasks. To determine the connection between cognitive function and intelligence, the psychiatric symptom, the number of years affected, and dosage of medication, we examined 2 subtests from the Wechsler Adult Intelligence Scale, 3rd Edition (WAIS-Ⅲ) and the Brief Psychiatric Rating Scale (BPRS) and researched medical chart information. The results of our examination show that patients who cannot draw shapes from their own viewpoint (loose 0-angle drawing) cannot draw them from another viewpoint (loose 180-angle drawing), and cannot draw to unified house, tree, or people on S-HTP. The order of difficulty of tasks for patients with schizophrenia, starting with the most difficult, was 180-angle drawing, S-HTP, and 0-angle drawing. Additionally, deficits in 0-angle drawing and S-HTP drawings were related to deficits in the ability to solve a new problem, and a deficit in 180-angle drawing was related to overall intelligence deficits. Our examination suggests that these three kinds of drawing are able to measure the cognitive level of function in patients with schizophrenia.