中国男性精神分裂症患者吸烟、精神病理学、认知功能和治疗相关不良反应的病例对照研究(英文)  

CIGARETTE SMOKING,PSYCHOPATHOLOGY,COGNITIVE FUNCTION AND MEDICATION SIDE EFFECTS IN CHINESE MALE SCHIZOPHRENIA:A CASE-CONTROL STUDY

作　　者：张向阳 曹连元[2] 陈大春[3] 綦凌燕[2] 陈松[2] 王帆[2] 修梅红[2] 吴桂英[2] 陆林[3] Thomas R Kosten 

机构地区：[1]The Menninger Department of Psychiatry and Behavioral Sciences,Baylor College of Medicine [2]北京市昌平区回龙观医院,北京100096 [3]北京大学中国药物依赖性研究所,北京100191

出　　处：《中国药物依赖性杂志》2009年第4期283-293,共11页Chinese Journal of Drug Dependence

基　　金：Supported by grants from the Stanley Medical Research Institute (03T-459 and 05T-726);the Department of Veterans Affairs,VISN16,Mental Illness Research,Education and Clinical Center(MIRECC) and National Institute on Drug Abuse K05-DA0454 and P50 -DA18827

摘　　要：目的:美洲和欧洲的精神分裂症患者的吸烟率是社区人群对照的3至4倍,与阴性症状和锥体外系综合征的减少及认知功能的改善有关。本研究的目的是在中国精神分裂症患者中观察这些因素的临床关联性。方法:采用尼古丁依赖自评量表(Fagerstrom Test for Nicotine Dependence,FTND)和重复性成套神经心理状态测验(Repeatable Battery for the Assessment of Neuropsychological Status,RBANS),我们对776例男性和560例男性社区对照进行了比较。患者也测评了阳性和阴性症状量表(Positive and Negative Symptom Scale,PANSS)、Simpson -Angus锥体外系副反应评定量表(Simpson and Angus Extrapyramidal Symptom Rating Scale,SAES)和不自主运动量表(Abnormal Involuntary Movement Scale,AIMS)。结果:精神分裂症患者终生吸烟率较社区对照人群高(79%比63%),同时严重吸烟者与对照组之间有更明显的差异(61%比31%)。现在吸烟者的PANSS阴性症状和SAES帕金森综合征得分均低于非吸烟者。吸烟的精神分裂症患者在RBANS认知功能测试中表现最差,非吸烟精神分裂症患者较差,之后是吸烟者,非吸烟者对照表现最好。结论:中国精神分裂症患者的吸烟率高于社区对照人群,但精神分裂症患者和对照组之间尼古丁依赖率与美洲观察到的情况有很大的差异。吸烟与较低水平的阴性症状,较少的锥体外系综合征及较少的帕金森综合征相关联,提示自我治疗的存在。但是,吸烟在精神分裂症患者和对照组人群中都与显著的认知功能损害相关联。Objective：Cigarette smoking rates are 3-4 times higher among American and European schizophrenics than community controls,and are associated with reduced negative and extrapyramidal symptoms and improved cognitive functioning. The aims of the present study were to examine these clinical associations in Chinese schizophrenics. Methods：We compared 776 male schizophrenics to 560 male community controls on the Fagerstrom Test for Nicotine Dependence （FTND） and on the Repeatable Battery for the Assessment of Neuropsychological Status （RBANS）. Patients also were administered the Positive and Negative Symptom Scale （PANSS）, the Simpson and Angus Involuntary Movement Scale （ AIMS）.Results： Lifetime Symptom Rating Scale （SAES）, and the Abnormal smoking was higher for the schizophrenics than community controls（79% vs 63% ）, and heavy smoking showed a greater difference from controls （61% vs 31% ）. The PANSS negative symptom and SAES Parkinsonism scores were lower in current smokers than non - smokers. Cognitive functioning on the RBANS was worst for smoking schizophrenics, then better for non - smoking schizophrenics, then smoking controls, and then non - smoking controls who scored best. Conclusion：Smoking rates in China are modestly higher among schizophrenics than community controls,but nicotine dependence rates show large differences between schizophrenics and controls that are found in America. Smoking is associated with lower negative symptoms and less Parkinsonism, suggesting self- medication. However, smoking in both schizophrenics and controls is associated with significant cognitive impairments.

关 键 词：精神分裂症 吸烟 精神病理学 认知 不良反应 尼古丁 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R749.16[医药卫生—临床医学]