认知功能与稳定期精神分裂症患者服药依从性关系的研究  

Relationship between cognitive functions and medication compliance in patients with schizophrenia at stable phase

作　　者：陈声云 夏晓伟[1] 赵崇邦 吴小立[1] Chen Shengyun;Xia Xiaowei;Zhao Chongbang;Wu Xiaoli(Department of Psychiatry,Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院精神(心理)科,广州510630

出　　处：《中华神经医学杂志》2019年第7期668-673,共6页Chinese Journal of Neuromedicine

基　　金：广东省科技计划项目(2016A020215075).

摘　　要：目的探讨认知功能对稳定期精神分裂症患者服药依从性的影响,为改善精神分裂症患者服药依从性提供临床应对策略。方法收集中山大学附属第三医院精神科自2017年5月至10月收治的238名精神分裂症患者临床资料并根据服药依从性量表(MARKS)将患者分为服药不依从组(得分≤4分者,n=32)及服药依从组(得分>4分者,n=206)。采用MATRICS共识认知成套测试(MCCB)、简明精神病评定量表(PRS)等评估2组患者认知功能差异及病情严重程度。采用多重线性回归分析明确影响稳定期精神分裂症患者服药依从性的相关因素。结果(1)服药依从组患者MCCB总分及各因子分(除外视觉学习)均高于服药不依从组患者;其中符号编码能力、空间广度、情绪管理能力的得分明显高于服药不依从组患者,差异有统计学意义(P<0.05)。(2)符号编码能力(神经认知)、情绪管理能力(社会认知)、病情严重程度以及抗精神病药物剂量是精神分裂症患者服药依从性的独立影响因素(P<0.05)。结论稳定期精神分裂症患者服药依从性不仅受到病情严重程度和抗精神病药物剂量的影响,还受到神经认知和社会认知功能的影响。Objective To elucidate the effect of cognitive functions on medication compliance of schizophrenia patients at stable phase, and provide clinical cognitive coping strategies to improve the medication compliance of schizophrenia patients. Methods Two hundred and thirty-eight schizophrenia patients at stable phase, admitted to psychiatry department of the 3rd affiliated hospital of Sun Yat-sen University from May 2017 to October 2017, and all study subjects were divided into without medication compliance group (the scores of medication compliance scale≤4, n=32) and medication compliance group (the scores of medication compliance scale>4, n=206) by Medication Adherence Rating Scale (MARS). MATRICS Consensus Cognitive Battery (MCCB) and Brief Psychiatric Rating Scale (BPRS) were used to evaluate the differences of cognitive performance and disease severity between groups. The factors influencing medication compliance of schizophrenia patients with stable phase were explored by multiple linear regression analysis. Results (1) The total scores of MCCB and it,s subscales scores (except for visual learning) of schizophrenia patients with medication compliance were higher than that of patients without medication compliance. The scores of symbol coding, spatial span and emotional intelligence ability in medication compliance group were significantly higher than those of patients without medication compliance (P<0.05).(2) Symbol coding (neurocognition ability), emotion management (social cognition ability), severity of illness, and antipsychotic drug dose were the independent influencing factors of medication compliance of schizophrenia patients with stable phase (P<0.05). Conclusion The medication compliance of schizophrenia patients with stable phase is not only affected by antipsychotics dose and severity of illness, but also affected by neurocognitive and social cognitive functions.

关 键 词：精神分裂症 神经认知 社会认知 服药依从性 

分 类 号：R749.3[医药卫生—神经病学与精神病学]