社区管理对老年精神分裂症患者认知功能影响的对照研究

Controlled Trial of the Influence of Community Management on the Cognitive Function of Older Patients with Schizophrenia

目的了解社区管理对老年精神分裂症患者认知功能的影响。方法收集从成都市第四人民医院老年病房出院的患者作为研究组(78例);住院患者作为对照组(86例)。评定工具包括一般情况量表、简易精神状态量表(The Mini-Mental State Examination,MMSE)和阳性阴性量表(The Positive and Negative Syndrome Scale,PANSS)。对研究组和对照组进行出院时(基线)、6个月、12个月3次评定。采用SPSS 13.0软件对数据进行统计分析。结果 6个月后,研究组和对照组的MMSE和PANSS评分结果差异无统计学意义(P>0.05);12个月后,研究组MMSE评分高于对照组(t=2.35,P=0.013),而PANSS评分差异无统计学意义(t=0.29,P=0.784)。通过自身前后比较(基线与12个月后比较),研究组和对照组的PANSS评分均有所降低:研究组(t=3.102,P=0.005),对照组(t=4.211,P=0.001 4)。结论社区管理治疗作为目前精神疾病防治的主要方式,它能改善老年精神分裂症患者的精神症状,而症状改善会影响认知功能。因此,本次研究难以认定社区管理能够改善老年精神分裂症患者的认知功能。

Objectives To explore the influence of community management on cognitive function of the old patients with schizophrenia.Methods We recruited the subjects（78） and the controls（86） from the Fourth People＇s Hospital of Chengdu.The evaluation tools including the common status questionnaire,the Mini-Mental State Examination（MMSE） and the Positive and Negative Syndrome Scale（PANSS） were used three time at the baseline time,6 months later and 12 months later respectively.SPSS 13.0 was employed in the data analysis.Results The controlled group and the subject group had statistical difference in MMSE check（t=2.35,P=0.013） but not PANSS 12 months later（t=0.29,P=0.784）,while they had no difference in both assessments at 6 moths later（P0.05）.We compared their own scores of baseline and 12 months later of the two groups.The results showed that the PANSS scores of both groups lessoned（the controlled group,t=3.102,P=0.005;the subject group,t=4.211,P=0.001 4）.Conclusions Community management could ameliorate older schizophrenia patients＇ symptoms,which could possibly affect patient＇s cognitive function.Therefore,we could not conclude that community management could improve the patient＇s cognitive function directly.