关注精神分裂症认知功能损害的干预与管理  

Focusing on the intervention and management of cognitive impairment in schizophrenia

作　　者：刘莎[1] 邓红[2] 于欣[3] 石川[3] 刘哲宁[4] 刘登堂[5] 张天宏[5] 陆峥[6] 李晓白[7] 蒲城城[3] Liu Sha;Deng Hong;Yu Xin;Shi Chuan;Liu Zhening;Liu Dengtang;Zhang Tianhong;Lu Zheng;Li Xiaobai;Pu Chengcheng(Department of Psychiatry,First Hospital of Shanxi Medical University,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder,Taiyuan030001,China;Mental Health Center,West China Hospital of Sichuan University,Chengdu610041,China;Peking University Sixth Hospital,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Health(Peking University),National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital),Beijing100191,China;Department of Psychiatry,the Second Xiangya Hospital of Central South University,National Clinical Research Center for Mental Disorders,National Center for Mental Disorders,Changsha410011,China;Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai200030,China;Mental Health Center,Tongji Hospital of Tongji University,Shanghai200065,China;Department of Psychiatry,the First Affiliated Hospital of China Medical University,Shenyang110001,China)

机构地区：[1]山西医科大学第一医院精神卫生科、精神障碍人工智能辅助诊疗山西省重点实验室,太原030001 [2]四川大学华西医院心理卫生中心,成都610041 [3]北京大学第六医院、北京大学精神卫生研究所、国家卫生健康委员会精神卫生学重点实验室(北京大学)国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100191 [4]中南大学湘雅二医院精神病学科、国家精神心理疾病临床研究中心、国家精神疾病医学中心,长沙410011 [5]上海交通大学医学院附属精神卫生中心,上海200030 [6]同济大学附属同济医院精神医学中心,上海200065 [7]中国医科大学附属第一医院精神科,沈阳110001

出　　处：《中华精神科杂志》2024年第12期801-807,共7页Chinese Journal of Psychiatry

基　　金：国家自然科学基金面上项目(82271546);四川省科技厅计划项目(22ZDYF2064, 2017FZ0064);山西省科技创新人才团队(202304051001049);山西省高等教育“百亿工程”科技引导专项(BYJL062);山西省留学人员科技活动择优资助项目(20240041)。

摘　　要：认知功能损害是精神分裂症的核心特征之一, 严重影响疾病预后。改善认知功能损害对于减轻精神分裂症患者的症状、预防复发、提高生活质量以及减轻社会负担等具有重要意义。基于2022年欧洲精神病学协会发布的《精神分裂症认知功能损害评估指引》, 我们重点关注精神分裂症患者在给予系统评估后如何进行干预和管理, 同时结合在中国的具体实践情况而撰写本述评。本文不仅回顾了精神分裂症认知功能损害的干预进展, 从药物治疗、物理治疗、心理治疗及其他干预方法等4个方面为临床实践提供指导依据, 同时对此领域仍然存在的问题及管理所面临的挑战等提出思考, 以期为目前精神分裂症认知功能损害的治疗提供决策依据。Cognitive impairment is one of the core features of schizophrenia and severely affects the prognosis of the disorder.Improving cognitive impairment is of great significance for alleviating symptoms,preventing relapses,enhancing the quality of life,and reducing the social burden in patients with schizophrenia.Based on the"Guidelines for the Assessment of Cognitive Impairment in Schizophrenia"published by the European Psychiatric Association in 2022,the article focuses on the intervention and management of cognitive impairment in schizophrenia patients following a systematic assessment,while also considering the specific context of practice in China.This paper reviews recent progress in cognitive impairment interventions for schizophrenia,providing clinical guidance across three key aspects:pharmacotherapy,physical therapy,and psychotherapy.Other interventions are also discussed.Additionally,it addresses the existing challenges and unresolved issues,aiming to provide a basis for decision-making in the current treatment of cognitive impairment in schizophrenia.

关 键 词：精神分裂症 认知功能损害 治疗 指引解读 

分 类 号：R749.3[医药卫生—神经病学与精神病学]