Viertiö Satu, Sainio Päivi, Koskinen Seppo, Perälä Jonna, Saarni Samuli I, Sihvonen Marja, Lönnqvist Jouko, Suvisaari Jaana
Dept. of Mental Health and Alcohol Research, National Public Health Institute, Mannerheimintie 166, Helsinki 00300, Finland.
Soc Psychiatry Psychiatr Epidemiol. 2009 Apr;44(4):325-32. doi: 10.1007/s00127-008-0433-y. Epub 2008 Sep 17.
There are few reports on mobility limitations in persons with psychotic disorder although restrictions in mobility may aggravate the general functional limitations of these patients. Our aim was to investigate mobility limitations among subjects with psychotic disorder in a general population-based sample.
A nationally representative sample of 6,927 persons aged 30 and older self-reported mobility limitations in an interview and was examined in performance tests. Diagnostic assessment of DSM-IV psychotic disorders combined SCID interview and case note data. Lifetime-ever diagnoses of psychotic disorder were classified into schizophrenia, other nonaffective psychotic disorders and affective psychoses.
Self-reported mobility limitations were highly prevalent in persons with schizophrenia and other nonaffective psychosis, but not in the affective psychosis group. After adjusting for age and sex, persons with schizophrenia and other nonaffective psychoses but not affective psychoses had significantly increased odds of having both self-reported and test-based mobility limitations as well as weak muscle strength. Schizophrenia remained an independent predictor of mobility limitations even after controlling for lifestyle-related factors and chronic medical conditions. Among persons with nonaffective psychoses, higher levels of negative symptoms predicted mobility limitations.
Self-reported mobility limitations are prevalent already at a young age in persons with schizophrenia and other nonaffective psychotic disorders, and among older persons with these disorders both self-reported limitations and measured performance tests show lower capacity in mobility. Difficulties in mobility are associated with negative symptoms. Mental health care professionals should pay attention to mobility limitations in persons with psychotic disorder.
尽管行动受限可能会加重精神病患者的总体功能限制,但关于精神病患者行动受限的报道较少。我们的目的是在一个基于普通人群的样本中调查精神病患者的行动受限情况。
一个具有全国代表性的6927名30岁及以上人群的样本在访谈中自我报告了行动受限情况,并接受了性能测试。采用DSM-IV精神病性障碍诊断评估,结合SCID访谈和病例记录数据。终生诊断为精神病性障碍的患者被分为精神分裂症、其他非情感性精神病性障碍和情感性精神病。
自我报告的行动受限在精神分裂症和其他非情感性精神病患者中非常普遍,但在情感性精神病组中并非如此。在调整年龄和性别后,精神分裂症和其他非情感性精神病患者(而非情感性精神病患者)自我报告和基于测试的行动受限以及肌肉力量薄弱的几率显著增加。即使在控制了与生活方式相关的因素和慢性疾病后,精神分裂症仍然是行动受限的独立预测因素。在非情感性精神病患者中,较高水平的阴性症状预示着行动受限。
自我报告的行动受限在精神分裂症和其他非情感性精神病性障碍患者中在年轻时就很普遍,在患有这些疾病的老年人中,自我报告的限制和实测性能测试都显示出较低的行动能力。行动困难与阴性症状有关。精神卫生保健专业人员应关注精神病患者的行动受限情况。