长期住院精神分裂症稳定期患者社会功能及影响因素  

Social function in long-term hospitalized patients with stable schizophrenia and its influential factors

作　　者：崔洪梅 周燕玲[1] 李冠男 李丹[1,2] 孙彬 范妮[1] CUI Hongmei;ZHOU Yanling;LI Guannan;LI Dan;SUN Bin;FAN Ni(The Affiliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital),Guangzhou 510370,China)

机构地区：[1]广州医科大学附属脑科医院(广州市惠爱医院)研究所,广州510370 [2]广州市民政局精神病院精神科

出　　处：《中国神经精神疾病杂志》2018年第11期673-677,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：广州市科技计划项目创新平台建设计划重点实验室"广州市精神疾病临床转化实验室"(编号:201805010009);广州市科技计划项目(编号:201607010131)

摘　　要：目的评估长期住院的精神分裂症稳定期患者社会功能及其影响因素,为临床工作中进一步采取措施改善患者的社会功能提供参考。方法纳入长期住院精神分裂症稳定期患者75例,采用阳性和阴性症状量表(positive and negative syndrome scale, PANSS)、锥体外系副反应量表(rating scale for extrapyramdal side effects,RSESE)、自知力与治疗态度问卷(insight and treatment attitude questionnaire, ITAQ)、精神分裂症认知功能成套测验共识版(the measurement and treatment research to improve cognition in schizophrenia consensus cognitive battery,MCCB)和社会功能量表(social functional rating scale, SFRS)分别评估患者的精神症状、锥体外系副反应、自知力、认知功能及社会功能,分析社会功能与临床症状及认知功能的关系,以及其中介效应。结果 SFRS平均(53.6±9.3)分。线性回归分析结果显示信息处理速度(B=-0.428, P<0.001)、工作记忆(B=-0.191, P=0.020)、RESES(B=0.918, P=0.002)、PANSS阴性症状(B=0.322, P=0.009)与SFRS关联有统计学意义。Sobel检验结果显示工作记忆(Z=3.367, P<0.001)及处理速度(Z=1.995, P=0.046)在PANSS阴性症状与SFRS间存在中介效应。结论长期住院的精神分裂症稳定期患者社会功能损害与阴性症状、信息处理速度、工作记忆、锥体外系副反应密切相关。工作记忆及处理速度在患者症状与社会功能间存在中介效应。Objective To explore social function of long-term hospitalized patients with stable schizophrenia and its influential factors to provide scientific evidence for improving social function in long-term hospitalized patients with schizophrenia.Methods A total of 75 long-term hospitalized patients with stable schizophrenia were enrolled.The Social Functional Rating Scale(SFRS),Positive and Negative Syndrome Scale(PANSS),Insight and Treatment Attitude Questionnaire(ITAQ),Rating Scale for Extrapyramdal Side Effects(RSESE)and MATRICS(Measurement and Treatment Research to Improve Cognition in Schizophrenia)Consensus Cognitive Battery(MCCB)were used to assess social function,clinical symptoms and cognitive function of patients.Bivariate correlation analysis and linear regression were used to examine the correlations between social function and clinical symptoms as well as cognitive function.Results The average score of SFRS was(53.6±9.3).Linear regression analysis showed that negative symptom of PANSS(B=0.322,P=0.009),speed of processing(B=-0.428,P<0.001),working memory(B=-0.191,P=0.020)and RESES(B=0.918,P=0.002)were significantly associated with social function.The Sobel test showed significant indirect effects between negative symptom and social function,which were significantly mediated by working memory(Z=3.367,P<0.001)and speed of processing(Z=1.995,P=0.046).Conclusion Social function of long-term hospitalized patients with stable schizophrenia is influenced by negative symptom,speed of processing,working memory and extrapyramdal side effects.There is a mediating effect between PANSS negative symptoms and SFRS in working memory and processing speed.

关 键 词：精神分裂症 长期住院 社会功能 影响因素 

分 类 号：R749.3[医药卫生—神经病学与精神病学]