首发精神分裂症患者近期和远期复发的相关因素

Factors Related to the Relapse of First-episode Schizophrenia

目的探讨引起首发精神分裂症患者近期和远期复发的相关因素。方法对164例首发精神分裂症患者进行长期随访,于治疗一年末、四年末各做一次韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、手指敲击试验、动作功能测验、手功能协调测验、连线测验A和B、威斯康星卡片分类测验(WCST)及言语流利性测验10项神经心理测查及治疗一年内每月一次BPRS、SDSS评定,治疗一年至四年内每三月一次BPRS、SDSS评定。我们分别根据患者治疗一年内和一年至四年的BPRS结果将患者分为复发组和未复发组,即一年内或一年至四年只要有一次复发就分到复发组,分别比较治疗一年末和四年末复发组和未复发组各项认知功能及年龄、受教育年限、DUP(未治疗的精神病期)等特征有无显著性差异。结果治疗一年末复发组的DUP显著长于未复发组(24.4±18.4/16.5±17.4,t=-2.19,P<0.05),其余各项指标差异均无统计学显著性;治疗四年末复发组和未复发组各项指标差异均无统计学显著性。结论首发精神分裂症患者的DUP长短与患者的近期预后有关,DUP越短,近期预后越好;DUP为近期内复发的相关因素。

Objective： Discuss factors related to the short-term relapse and long-term relapse of first-episode schizophrenia patients. Methods： 10 cognitive function tests were administered -Weschler Adult Intelligence Scale,Weschler Memory Scale, Grooved Pegboard Test, Finger Tapping Test, a motor function test, a hand coordination test,Trail Making Test A and B, Wisconsin Card Sort Test, and a verbal fluency test at end of lyear and 4year after staringtreatment. We also evaluated BPRS and SDSS each month in 1 year , and evaluated BPRS and SDSS each 3 -month inlycar to 4year. Patients were divided in two groups according to BPRS score at lyear and 4 year ： relapse group andnot relapse group. Relapse criterion： patients relapsed in lyear or lyear to 4year into relapse group, others into not relapse group. We compared cognitive function, age, educational level, DUP （Duration of Untreated Psychosis） of relapse group versus not relapse group at end of lyear and 4year. Results： At end of lyear, DUP showed significantlylonger of relapse group than not relapse group （ 24. 4±18.4/16. 5±17. 4, t = - 2. 19, P 〈 0. 05 ） , other items nosignificant difference between the two groups （ P 〉 0.05 ） . At end of 4year, there was no significant difference between the two groups （ P 〉 0.05 ）. Conclusion ： DUP related to short-term prognosis of first-episode schizophrenia patients, the DUP is shorter, the prognosis is better. DUP was related factor of relanse.