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青少年精神分裂症患者在以非典型抗精神病药物为主的治疗下运动障碍与精神病理学之间的关系。

Relations between movement disorders and psychopathology under predominantly atypical antipsychotic treatment in adolescent patients with schizophrenia.

作者信息

Gebhardt Stefan, Härtling Fabian, Hanke Markus, Theisen Frank M, von Georgi Richard, Grant Phillip, Mittendorf Markus, Martin Matthias, Fleischhaker Christian, Schulz Eberhard, Remschmidt Helmut

机构信息

Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Rudolf-Bultmann-Str. 8, 35033 Marburg, Germany.

出版信息

Eur Child Adolesc Psychiatry. 2008 Feb;17(1):44-53. doi: 10.1007/s00787-007-0633-0. Epub 2007 Sep 14.

Abstract

OBJECTIVE

To examine relations between movement disorders (MD) and psychopathological symptoms in an adolescent population with schizophrenia under treatment with predominantly atypical antipsychotics.

METHOD

MD symptoms and psychopathology were cross-sectionally assessed in 93 patients (aged 19.6 +/- 2.2 years) using Tardive Dyskinesia Rating Scale (TDRS), Abnormal Involuntary Movement Scale (AIMS), Extrapyramidal Symptom Scale (EPS), Barnes Akathisia Scale (BAS), Brief Psychiatric Rating Scale (BPRS) and the Schedule for Assessment of Negative/Positive Symptoms (SANS/SAPS).

RESULTS

All patients with MD symptoms (n = 37; 39.8 %) showed pronounced global psychpathological signs (SANS/SAPS, BPRS: p = 0.026, p = 0.033, p = 0.001) with predominant anergia symptoms (p = 0.005) and inclinations toward higher anxiety- and depression-related symptoms (p = 0.051) as well as increased thought disturbance (p = 0.066). Both negative symptoms and anergia showed trends for positive correlations with tardive dyskinesia (p = 0.068; p = 0.065) as well as significant correlations with parkinsonism symptoms (p = 0.036; p = 0.023). Akathisia symptoms correlated significantly with hostile and suspicious symptoms (p = 0.013). A superfactor-analysis revealed four factors supporting the aforementioned results.

CONCLUSION

MD symptoms and psychopathology are in some respects related to each other. Motor symptoms representing on the one hand trait characteristics of schizophrenia might additionally be triggered by antipsychotics and finally co-occur with more residual symptoms within a long-term treatment.

摘要

目的

研究在主要使用非典型抗精神病药物治疗的青少年精神分裂症患者中,运动障碍(MD)与精神病理症状之间的关系。

方法

采用迟发性运动障碍评定量表(TDRS)、异常不自主运动量表(AIMS)、锥体外系症状量表(EPS)、巴恩斯静坐不能量表(BAS)、简明精神病评定量表(BPRS)以及阴性/阳性症状评定量表(SANS/SAPS),对93例患者(年龄19.6±2.2岁)的MD症状和精神病理学进行横断面评估。

结果

所有有MD症状的患者(n = 37;39.8%)均表现出明显的整体精神病理体征(SANS/SAPS、BPRS:p = 0.026,p = 0.033,p = 0.001),主要为无力症状(p = 0.005),并有更高的焦虑和抑郁相关症状倾向(p = 0.051)以及思维紊乱增加(p = 0.066)。阴性症状和无力症状均显示出与迟发性运动障碍呈正相关趋势(p = 0.068;p = 0.065),与帕金森症状呈显著相关(p = 0.036;p = 0.023)。静坐不能症状与敌对和猜疑症状显著相关(p = 0.013)。一项超因素分析揭示了支持上述结果的四个因素。

结论

MD症状与精神病理学在某些方面相互关联。一方面代表精神分裂症特质特征的运动症状可能还会由抗精神病药物引发,并最终在长期治疗中与更多残留症状同时出现。

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