首发精神分裂症患者吸烟与精神症状特点及认知功能的关系  

Association of Smoking and Psychiatric Symptoms,Clinical Characteristics and Cognitive Function in First-episode Schizophrenia Patients

作　　者：陈大春[1] 张向阳[1] 李艳丽[1] 王宁[1] 聂鹰[1] 杨可冰[1] 谭云龙[1] 周东丰[2] 

机构地区：[1]北京回龙观医院二科,北京100096 [2]北京大学精神卫生研究所,卫生部精神卫生学重点实验室(北京大学),北京100191

出　　处：《中国心理卫生杂志》2009年第1期1-4,9,共5页Chinese Mental Health Journal

基　　金：美国斯坦利基金(03T-459和5T-726)

摘　　要：目的:探讨首发精神分裂症患者吸烟与精神症状及认知功能的关系。方法:符合美国精神障碍诊断与统计手册第四版(DSM-IV)诊断标准的首发精神分裂症住院病人90例,其中吸烟患者27例,非吸烟患者63例,使用住院病人烟草使用状态调查表、尼古丁依赖严重程度量表(FTND)对患者吸烟状况进行调查,使用阳性和阴性症状量表(PANSS)、汉密尔顿抑郁量表(HAMD)评定临床症状,威斯康星卡片分类(WCST)、重复性成套神经心理状态测验(RBANS)检测认知功能。结果:首发精神分裂症男性患者吸烟检出率为50.0%,女性患者为7.1%。平均烟龄为(10.7±6.8)年,开始尝试吸烟时平均年龄为(16.7±4.8)岁,平均每日吸烟量为(13.5±10.8)支,吸烟组患者PANSS总分、阴性症状量表分、一般精神病理症状量表分均高于非吸烟组[(91.3±20.9)vs.(80.6±17.2),(20.7±8.6)vs.(17.4±6.3),(43.4±12.3)vs.(38.2±10.8);均P<0.05];非吸烟组的正确应答数高于吸烟组[(50.6±18.2)vs.(42.2±14.3),P<0.05],而错误应答数低于吸烟组[(75.5±21.9)vs.(85.3±15.8),P<0.05]。首次精神症状发生年龄、首次住院年龄与烟龄呈正相关(r=0.73,0.75),一般精神病理学症状分与FTND分呈负相关(r=-0.47),开始尝试吸烟年龄与RBANS总分、延时记忆得分呈正相关(r=0.57,0.58)。结论:精神分裂症精神症状、认知功能受损程度重于非吸烟患者,提示吸烟与精神症状,认知功能存在着一定相关性。Objective： To explore relationship between smoking and psychiatric symptoms and cognitive function in first-episode schizophrenia. Methods： Ninety first-episode schizophrenia inpatients （ DSM-IV criteria ） were enrolled, including 27 smoking and 63 nonsmoking individuals. The smoking status were assessed with the Inpatients Smoking Status Scale and Fagerstrom Test for Nicotine Dependence （ FTND）, the clinical symptoms were assessed with the Positive and Negative Syndrome Scale （ PANSS ） and Hamilton Rating Scale for Depression （ HAMD ）, and the cognitive functions were assessed with the Wisconsin Card Sorting Test （WCST） and Repeatable Battery for the Assessment of Neuropsychological Status （RBANS） . Results： Detection rates of smoking were 50.0% in male and 7. 1% in female patients, respectively. Mean duration of smoking was （ 10. 7 ± 6. 8 ） years, mean age of attempting to smoke was （ 16. 7 ±4. 8） years old, and mean amount of cigarettes smoked was （ 13.5 ± 10. 8） everyday. The PANSS score and sub-scores of negative symptoms and general psychopathology in smoking group were significantly higher than that in nonsmoking group [ （91.3±20.9） vs. （80.6±17.2）, （20.7±8.6） vs. （17.4±6.3}, （43.4±12.3） vs. （ 38. 2 ± 10. 8 ） ; P 〈 0. 05 ] . The replies correct and replies error of WCST were significantly different between smoking and nonsmoking groups [ （50. 6 ± 18. 2） vs. （ 42. 2 ± 14. 3 ）, （75.5 ± 21.9） vs. （ 85.3 ± 15.8 ）, P 〈 0. 05 ] .Smoking age was positively correlated with age of the first onset of disease and age of the first admitted to hospital （ r = 0. 73, 0. 75 ） . Score of FTND was significantly negative correlated with sub-score of general psychopathology （ r = - 0. 47 ） . Age of attempting to smoking was significantly positive correlated with RBANS and delayed memory scores （ r = 0. 57, 0. 58 ） . Conclusion： Psycho-symptoms and cognitive function of smoking patients are more severe than nonsmoking

关 键 词：首发精神分裂症 吸烟 精神症状 认知功能 横断面研究 

分 类 号：R749.3[医药卫生—神经病学与精神病学]