Die Untersuchung von Aufmerksamkeit, Aktivität und Impulsivität bei an Schizophrenie erkrankten Kindern und Jugendlichen mit Hilfe des „QbTest“

Disorders of attention, impulsivity and motor activity are common symptoms in child and adolescent psychiatry. Aim of this study was to get objective information about these three parameters by using the QbTest. Of all n= 502 patients that were admitted to child- and adolescent psychiatry and psychotherapy of the Philipps-University of Marburg from 1.June 2004 until 31. December 2005, n=315 patients (=63%) were tested by the QbTest at the beginning and the end of their admission and assigned to different groups according to their main diagnose. As part of this overall project of several studies, this paper presents the test-results of schizophrenic patients (n=22) and compares them with four other groups of patients with different diagnoses: mood (affective) disorders (F30-39; n=20), neurotic, stress-related and somatoform disorders (F40-48; n=68); eating disorders (F50-58; n=41) and conduct disorders (F91.0-91.8; n=31). Most patients were also tested with the d2-test for internal validation. We further looked for potential correlation of tested parameters with medication, psychosocial adjustment and the amount of psychiatric symptoms. Schizophrenic patients significantly reduced scores in the attention parameters as compared patients, suffering from eating-disorders (p<0,001) and patients with neurotic disorders (p=0,003). In addition they were Characterized by higher motor activity levels than patients with eating disorders (p=0,021). There was no significant difference regarding measured impulsivity between the diagnostic groups. We found a negative correlation between the QbTest-parameters for inattention and the parameters for attention of d2-test: all patients: r= -0,438; p<0,01; schizophrenic patients: r= -0,635; p<0,01. Regarding schizophrenic patients, attention improved between the first and second test (Effect size: 0,22) whereas parameters of motor activity and impulsivity did not show any difference. In the group of schizophrenic patients, a positive correlation between inattention and the amount of psychiatric symptoms was found (r=0,62; p=0,006). There was no correlation between test-results and medication or psychosocial adjustment. Our test-results were able to confirm deficits of attention in schizophrenic patients compared to patients with some other psychiatric diagnoses. During inpatient treatment attention improved in schizophrenic patients. A possible reason for this improvement might be adequate treatment with atypical neuroleptic drugs but a possible training-effect within the study cannot be excluded. Main limitations of this study were the absence of normative data for the Qb-Test, a relatively small number of patients and different medication and clinical symptoms of the enrolled patients. In summary our data suggest that the QbTest can be used as an acceptable tool for objective diagnostic evaluation of neuropsychological symptoms. The application of the QbTest in the future might comprise studies to monitor attention, impulsivity and motor activity during the course of treatment in different groups of psychiatric patients, including possible drug effects.