Han Mei, Zhang Xiang Yang, Chen Da Chun, Tan Yun Long, Song Chong Sheng, Yu Ying Hua, Huang Xu Feng
aSchool of Medicine, Faculty of Science, Medicine and Health, Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong bSchizophrenia Research Institute, Sydney, New South Wales, Australia cBiological Psychiatry Centre, Beijing Hui-Long-Guan Hospital, Peking University, Beijing, People's Republic of China dDepartment of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Int Clin Psychopharmacol. 2015 Mar;30(2):89-95. doi: 10.1097/YIC.0000000000000066.
Cognitive deficits are a core feature of schizophrenia. There is ongoing debate on whether cognition is affected by antipsychotic drugs (APDs). This study examined the effect of long-term treatment with APDs on cognition in schizophrenia. Cognitive function was assessed in 418 patients with schizophrenia on long-term treatment with APDs (215 on clozapine, 91 on risperidone and 112 on typical APDs) and 159 healthy controls using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Schizophrenia symptomatology was assessed using the Positive and Negative Syndrome Scale (PANSS). We found that cognitive test scores were significantly lower in all patients compared with the healthy controls on almost all of the total and subscores of RBANS (all P<0.001), except for the visuospatial/constructional index. Individuals taking clozapine showed worse immediate and delayed memory performance than those taking typical APDs (all P<0.01). Moreover, individuals taking clozapine showed better language performance than those taking risperidone (P<0.01). Immediate memory and delayed memory were modestly correlated with the types of APDs and the PANSS negative scores. Our results show that individuals taking clozapine performed worse in immediate and delayed memory than those taking typical APDs, but exemplified better language performance than those taking risperidone.
认知缺陷是精神分裂症的核心特征。关于认知是否受抗精神病药物（APDs）影响，目前仍存在争议。本研究考察了长期使用APDs治疗对精神分裂症患者认知的影响。使用可重复神经心理状态评估量表（RBANS）对418例长期接受APDs治疗的精神分裂症患者（215例使用氯氮平，91例使用利培酮，112例使用传统APDs）和159名健康对照者的认知功能进行了评估。使用阳性和阴性症状量表（PANSS）评估精神分裂症症状。我们发现，几乎在RBANS的所有总分和子分数上，所有患者的认知测试得分均显著低于健康对照者（所有P<0.001），视觉空间/结构指数除外。服用氯氮平的个体在即时和延迟记忆表现上比服用传统APDs的个体更差（所有P<0.01）。此外，服用氯氮平的个体在语言表现上比服用利培酮的个体更好（P<0.01）。即时记忆和延迟记忆与APDs类型及PANSS阴性分数呈适度相关。我们的结果表明，服用氯氮平的个体在即时和延迟记忆方面比服用传统APDs的个体表现更差，但在语言表现上比服用利培酮的个体更好。
