Fan Xiaoduo, Henderson David C, Nguyen Dana D, Cather Corinne, Freudenreich Oliver, Evins A Eden, Borba Christina P, Goff Donald C
Schizophrenia Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Psychiatry Res. 2008 May 30;159(1-2):140-6. doi: 10.1016/j.psychres.2007.10.012. Epub 2008 Apr 21.
The purpose of the present study was to assess posttraumatic stress disorder (PTSD), cognitive function, and quality of life in patients with schizophrenia who had a self-reported history of trauma exposure. Outpatients diagnosed with schizophrenia or schizoaffective disorder were referred to the study. Each patient was assessed with the Positive and Negative Syndrome Scale (PANSS), the Harvard Trauma Questionnaire (HTQ), a cognitive assessment battery, Heinrich's Quality of Life Scale (QLS), and the Behavior and Symptom Identification Scale (BASIS). Eighty-seven subjects who reported experiencing at least one traumatic event were included in the study. Fifteen of 87 (17%) met the DSM-IV criteria for PTSD. The PTSD group had significantly worse overall cognitive performance than the non-PTSD group, especially in the domains of attention, working memory and executive function. In addition, the PTSD group showed significantly worse self-rated quality of life as measured by the BASIS total score. The development of PTSD is associated with poor cognitive function and subjectively, but not objectively, rated low quality of life in patients with schizophrenia. Evaluating PTSD in patients with schizophrenia could have important implications from both clinical and research perspectives.
本研究的目的是评估有自我报告创伤暴露史的精神分裂症患者的创伤后应激障碍(PTSD)、认知功能和生活质量。被诊断为精神分裂症或分裂情感性障碍的门诊患者被纳入该研究。每位患者均接受阳性和阴性症状量表(PANSS)、哈佛创伤问卷(HTQ)、一套认知评估测试、海因里希生活质量量表(QLS)以及行为和症状识别量表(BASIS)的评估。报告经历过至少一次创伤事件的87名受试者被纳入该研究。87名受试者中有15名(17%)符合DSM-IV创伤后应激障碍的标准。创伤后应激障碍组的总体认知表现明显比非创伤后应激障碍组差,尤其是在注意力、工作记忆和执行功能方面。此外,根据BASIS总分衡量,创伤后应激障碍组的自我评定生活质量明显更差。创伤后应激障碍的发生与精神分裂症患者的认知功能差以及主观(而非客观)评定的低生活质量相关。评估精神分裂症患者的创伤后应激障碍从临床和研究角度来看可能都具有重要意义。