Strassnig Martin, Harvey Philip D
Dr. Harvey is Professor and Chief of Psychology and Dr. Strassnig is Assistant Professor and Director of ECT Services-Both with the Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida.
Innov Clin Neurosci. 2013 Jul;10(7-8):15-9.
Despite 50 years of pharmacological and psychosocial interventions, schizophrenia remains one of the leading causes of disability. The inability to function in everyday settings includes deficits in performance of social, occupational, and independent living activities. Schizophrenia is also a life-shortening illness, caused mainly by poor physical health and its complications. Dysfunctional lifestyles including sedentary behavior and lack of physical activity prevail, while treatment with adipogenic psychotropic medication interacts with poor performance in screening, monitoring, and intervention that result in shortening of life expectancies by 25 to 30 years. Disability interferes with self-care and medical care, further worsening physical health to produce a vicious cycle of disability. Further, the neurobiological impact of obesity on brain functioning is substantial and relevant to schizophrenia. Simultaneous treatment of cognitive deficits and related deficits in functional skills, ubiquitous determinants of everyday functioning in schizophrenia, and targeted interventions aimed at poor physical health, especially obesity and associated comorbidities, may lead to additive or even interactive gains in everyday functioning in patients with schizophrenia not previously realized with other interventions.
尽管经过了50年的药物和心理社会干预，精神分裂症仍然是导致残疾的主要原因之一。在日常环境中无法正常发挥功能包括社交、职业和独立生活活动表现方面的缺陷。精神分裂症也是一种缩短寿命的疾病，主要由身体健康状况不佳及其并发症引起。功能失调的生活方式普遍存在，包括久坐不动和缺乏体育活动，而成脂性精神药物治疗在筛查、监测和干预方面表现不佳，导致预期寿命缩短25至30年。残疾会干扰自我护理和医疗护理，进一步恶化身体健康，从而产生残疾的恶性循环。此外，肥胖对大脑功能的神经生物学影响很大，且与精神分裂症相关。同时治疗认知缺陷以及精神分裂症日常功能中普遍存在的功能技能相关缺陷，以及针对身体健康不佳，尤其是肥胖和相关合并症的针对性干预措施，可能会在精神分裂症患者的日常功能方面带来其他干预措施以前未实现的累加甚至交互增益。
