不同性别住院老年精神分裂症患者临床特征分析  

Analysis on clinical characteristics in different genders of elderly inpatients with schizophrenia

作　　者：鲍丽 占归来 李晨虎[1] 班春霞[3] 李霞[2] BAO Li;ZHAN Guilai;LI Chenhu;BAN Chunxia;LI Xia(Department of Psychiatry,Xuhui District Mental Health Center,Shanghai 200232,China;Department of Psychiatry,Shanghai Municipal Mental Health Center,Shanghai 200030,China;Department of Psychiatry,Jiading District Mental Health Center,Shanghai 201822,China)

机构地区：[1]上海市徐汇区精神卫生中心精神科,上海200232 [2]上海市精神卫生中心精神科,上海200030 [3]上海市嘉定区精神卫生中心精神科,上海201822

出　　处：《现代医药卫生》2021年第6期910-913,919,共5页Journal of Modern Medicine & Health

基　　金：上海市徐汇区科委面上项目(SHXH201916);上海市徐汇区医学高峰学科建设项目(SHXH201717)。

摘　　要：目的探讨老年精神分裂症患者的临床症状、认知功能、日常生活能力的性别差异。方法选取2018年6-12月上海市徐汇区精神卫生中心、上海市嘉定区精神卫生中心收治住院的符合国际疾病分类第10版精神分裂症诊断标准的老年精神分裂症患者194例,其中男101例(男性组),女93例(女性组)。使用自编临床基本特点调查表调查患者临床资料,比较2组患者阳性和阴性症状量表、老年抑郁量表、蒙特利尔认知评估量表、日常生活能力量表评分等。结果男性组患者阳性和阴性症状量表总分[(57.40±14.83)分]、阳性症状量表评分[(10.70±4.82)分]、阴性症状量表评分[(16.52±6.73)分]、一般精神病理症状量表评分[(25.58±5.63)分]、日常生活能力量表评分[(23.23±8.45)分]均明显低于女性组[分别为(66.03±4.50)、(13.08±6.90)、(18.77±8.07)、(29.95±10.26)、(28.48±11.10)分],蒙特利尔认知评估量表总分[(16.22±6.17)分]明显高于女性组[(13.47±5.99)分],差异均有统计学意义(P<0.05);男性组患者老年抑郁量表总分[(10.19±6.08)分]与女性组(10.11±6.13)分]比较,差异无统计学意义(P>0.05)。结论住院老年精神分裂症患者在阳性、阴性和一般精神病理症状、认知功能、日常生活能力等方面均存在性别差异,在抑郁症状方面性别差异不显著。提示临床医师对不同性别老年精神分裂症患者在预防、治疗和康复方面应有所区别,注重个体化。Objective To explore the gender differences in clinical symptoms,cognitive function and daily living abilities of elderly schizophrenic patients.Methods A total of 194 elderly patients with schizophrenia meeting the diagnostic criteria of the10 th edition of the International Classification of Diseases(ICD-10)for schizophrenia,including 101 male patients and 93 female patients.The patient′s clinical data were investigated by using the self-compiled clinical basic characteristics questionnaire.The scores of the Positive and Negative Symptoms Scale(PANSS),Geriatric Depression Scale(GDS),Montreal Cognitive Assessment Scale(MoCA)and Daily Living Ability Scale(ADL)were compared between the two groups.Results The PANSS total score,positive symptom scale score,negative symptom scale score,general psychopathological symptoms scale score and ADL score in the male group were significantly lower than those in the female group[(57.40±14.83)vs.(66.03±4.50),(10.70±4.82)vs.(13.08±6.90),(16.52±6.73)vs.(18.77±8.07),(25.58±5.63)vs.(29.95±10.26),(23.23±8.45)vs.(28.48±11.10);P<0.05];the total MoCA score in the male group was significantly higher than that in the female group,and the difference was statistically significant[(16.22±6.17)vs.(13.47±5.99),P<0.05].There was no statistically significant difference in the total GDS score between the two groups[(10.19±6.08)vs.(10.11±6.13),P>0.05].Conclusion There are the gender differences in the aspects of the positive,negative and general psychopathological symptoms,cognitive function and daily living ability of elderly schizophrenic inpatients.The gender difference in depression symptoms is not significant,suggesting that clinicians should make the difference in the aspects of prevention,treatment and rehabilitation,and focus on the individualization.

关 键 词：精神分裂症 住院病人 老年人 性别因素 认知 

分 类 号：R749.3[医药卫生—神经病学与精神病学]