Arango C, Adami H, Sherr J D, Thaker G K, Carpenter W T
Maryland Psychiatric Research Center, University of Maryland Medical School, Baltimore, USA.
Am J Psychiatry. 1999 Jul;156(7):1097-9. doi: 10.1176/ajp.156.7.1097.
The purpose of this study was to determine whether lack of awareness of motor dysfunction and lack of insight into mental dysfunction are related and to evaluate the longitudinal stability of lack of awareness of abnormal movements in schizophrenia.
Forty-three patients with schizophrenia and tardive dyskinesia participated in the study. The Scale of Unawareness of Mental Disorder was used to assess insight. All patients still meeting inclusion criteria after 2 years (N = 16) were reevaluated at follow-up.
Twenty (46.5%) of the 43 patients had at least moderate unawareness of their tardive dyskinesia. Awareness of tardive dyskinesia was only modestly related to two of the five dimensions of insight into mental disorder assessed. Patients with the deficit syndrome showed significantly less awareness of their tardive dyskinesia than patients without the deficit syndrome. Lack of awareness of tardive dyskinesia was stable over time.
Lack of awareness of tardive dyskinesia is a common feature in schizophrenia and is stable over time. Since patients are often unaware of dyskinesia, direct clinical examination is required to identify early tardive dyskinesia.
本研究旨在确定对运动功能障碍缺乏认知与对精神功能障碍缺乏洞察力是否相关，并评估精神分裂症患者对异常运动缺乏认知的纵向稳定性。
43例患有精神分裂症和迟发性运动障碍的患者参与了本研究。使用精神障碍无认知量表评估洞察力。2年后仍符合纳入标准的所有患者（N = 16）在随访时进行了重新评估。
43例患者中有20例（46.5%）至少对其迟发性运动障碍存在中度无认知。迟发性运动障碍的认知仅与所评估的精神障碍洞察力五个维度中的两个有适度关联。有缺陷综合征的患者对其迟发性运动障碍的认知明显低于无缺陷综合征的患者。对迟发性运动障碍的无认知随时间推移较为稳定。
对迟发性运动障碍的无认知是精神分裂症的一个常见特征，且随时间推移较为稳定。由于患者通常未意识到运动障碍，因此需要直接的临床检查来识别早期迟发性运动障碍。
