Evans J D, Negron A E, Palmer B W, Paulsen J S, Heaton R K, Jeste D V
Department of Psychiatry, University of California, San Diego 92161, USA.
J Geriatr Psychiatry Neurol. 1999 Spring;12(1):11-5. doi: 10.1177/089198879901200104.
We evaluated psychiatric symptoms and neurocognitive functioning among 25 institutionalized and 25 outpatient DSM-IV-diagnosed schizophrenia patients, as well as 25 middle-aged and elderly normal comparison subjects. All subjects were assessed with the Positive and Negative Syndrome Scale, Hamilton Rating Scale for Depression, modified Simpson-Angus Extrapyramidal Symptom Scale, the Abnormal Involuntary Movement Scale, and the Mattis Dementia Rating Scale (DRS). The two patient groups had similar levels of depressive symptoms, but the institutionalized patients had more severe positive and negative symptoms and were on higher doses of neuroleptic medication. The institutionalized patients had significantly more cognitive impairment on the DRS than outpatients and normal comparison subjects, particularly on the subscales of initiation/perseveration, conceptualization, and memory. Results are discussed in terms of the possible neuropathology associated with cognitive impairment in chronic schizophrenia.
我们评估了25名住院的和25名门诊的经《精神疾病诊断与统计手册》第四版（DSM-IV）诊断的精神分裂症患者以及25名中老年正常对照者的精神症状和神经认知功能。所有受试者均接受了阳性与阴性症状量表、汉密尔顿抑郁评定量表、改良的辛普森-安格斯锥体外系症状量表、异常不自主运动量表以及马蒂斯痴呆评定量表（DRS）的评估。两组患者的抑郁症状水平相似，但住院患者的阳性和阴性症状更为严重，且服用的抗精神病药物剂量更高。与门诊患者和正常对照者相比，住院患者在DRS上的认知损害明显更多，尤其是在起始/持续、概念化和记忆等分量表上。我们从与慢性精神分裂症认知损害相关的可能神经病理学角度对结果进行了讨论。
