男性慢性精神分裂症患者吸烟与精神病理症状关系的研究

Relations of smoking and psychopathological symptoms in male patients with chronic schizophrenia

目的探讨吸烟是否可以减少抗精神病药物的副作用,缓解精神分裂症的阴性症状。方法共纳入376例男性慢性精神分裂症患者,其中吸烟者和非吸烟者各188例,使用Fagerstrom尼古丁依赖量表(FTND)检查尼古丁依赖严重程度。采用阳性和阴性症状量表(PANSS),锥体外系副作用量表和异常不自主运动量表(AIMS)评定患者的精神症状和不良反应。结果男性慢性精神分裂症吸烟患者PANSS的阴性症状分和帕金森症状分比不吸烟患者显著减少(P=0.008;P=0.02),而吸烟和非吸烟者在PANSS的阳性症状分、一般精神病理症状分和总分以及异常不自主运动量表(AIMS)均无显著性差异(所有P>0.05)。结论吸烟能显著改善慢性精神分裂症的阴性症状,并减轻药物所致的锥体外系副作用,结果支持吸烟是精神分裂症"自我治疗假说"。

Objective To explore the relations of smoking with side effects of antipsychotic drugs and negative symptoms in male patients with chronic schizopheria. Methods A total of 376 male patients with chronic schizophrenia enrolled the study. They were evaluated with Fagerstrom Test for Nicotine Dependence （FTND）, Positive and Negative Symptoms Scale （PANSS）, the Simpson and Angus Extrapyramidal Symptom Rating Scale （SAES）, and the Abnormal Involuntary Movement Scale （AIMS）. Results The negative symptoms factor score of PANSS and parkinsonism symptom factor score of SAES in patients with smoking were significantly lower than those in patients without smoking. However, there had no significant differences in total score, positive symptoms and general psychotic symptoms factor scores of PANSS and AIMS score between two groups. Conclusion Smoking could improve negative symptoms and relieve extrapyramidal side effects induced by antipsychotic drugs.