首发精神分裂症未治疗时间对认知功能及预后的影响

Influence of duration of untreated psychosis on cognitive functions and prognosis of drug-naive patients with first-episode schizophrenia

目的探讨精神病未治疗时间（DUP）对首发精神分裂症患者认知功能及预后的影响。方法选取68例未服药首发患者，应用精神分裂症首发症状评定量表（SOS）确定DUP，按照DUP中位值分为短DUP（n=33）组和长DUP组（n=35），分别于基线、治疗后3个月、12个月分别采用WCST、P300测定认知功能，并与35例正常对照比较。采用重复测定资料的方差分析，比较2组患者认知功能的差异。结果①治疗前，2组患者认知功能与对照组差异均有统计学意义（P=0．000～0．006），与长DUP患者相比，短DUP患者除在分类完成数、P300潜伏期无差异外（P=0．393、0．484），其他认知功能评定的差异均有统计学意义（P=0．000～0．046）；②治疗后，长DUP组患者认知功能部分恢复，但仍有异于对照组，差异有统计学意义（P=0．000～0．026），短DUP组患者仅在分类完成数、P300波幅与对照组的差异仍有统计学意义（P=0．042、0．000）；③治疗后，除分类完成数外，短DUP组患者认知功能恢复均优于长DUP组，差异有统计学意义（F=4．258～6．764，P=0．017～0．045）。结论DUP对首发精神分裂症患者认知功能预后有重要影响。预防长DUP的发生，将有助于认知功能的恢复。

Objective To explore the influence of duration of untreated psychosis （DUP） on the cognitive functions and prognosis of drug-naive patients with first episode schizophrenia. Methods A total of sixty-eight drug-naive patients with first episode schizophrenia were randomly （by DUP） divided into short DUP group （n = 33 ） and long DUP group （n = 35）. The WCST and P300 were used to evaluate the cognitive function at baseline,3rd month and 12th month after the treatment, and the results were contrasted with 35 health controls. ANOVA was used to analyze the data. Results ①Be- fore the treatment, there were significantly differences in the cognitive function （ P = 0. 000 - 0. 006 ） between the DUP group and the control group ; there was significantly difference in cognitive function （ P = 0. 000 - 0. 046 ） between short DUP group and long DUP group, except completing the number of classification and latency of P300 （P = 0.393,0. 484 ）. ②After the treatment, there were still significantly differences in cognitive function between the long DUP group and con- trol group（ P = 0. 000 - 0.026）, though the cognitive function of patients in the long DUP group was improved at some ex- tent;However, there were significantly differences only in completing the number of classification and amplitude of P300 in short DUP group （ P = 0. 042,0. 000 ） ; ③After the treatment, the cognitive function of the patients in short DUP was recov- ered obviously as compared with the patient in the long DUP, the differences by ANOVA was significant （F = 4. 258 - 6. 764,P = 0. 017 - 0.045 ） except in completing the number of classification. Conclusion DUP had adverse effect on the cognitive functions of schizophrenia patients. To reduce the prevalence of long DUP should improve the recovery of the cognitive function of patients.