Gu Yan, Peng Hong, Dai Jingjing, Gao Hui, Yang Xianghong, Sheng Jialing, Zhang Chen
Department of Psychiatry, Shanghai Civil Affairs First Mental Health Center, Shanghai, China.
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Gen Psychiatr. 2018 Nov 1;31(2):e000011. doi: 10.1136/gpsych-2018-000011. eCollection 2018.
The impairment of social function is widespread in the patients with chronic schizophrenia, which seriously affects family, life and work conditions.
The main purpose of this study was to investigate the efficacy of paliperidone in the treatment of social function in chronic schizophrenia.
A total of 81 patients who met the standard criteria for schizophrenia and long-term hospitalised inpatients were randomly divided into the treatment group and normal control group following a 1- year prospective follow-up study. The reatment group (41 cases) used paliperidone extended-release tablets for reducing dosage, as appropriate, based on the original treatment strategy; and the control group (40 cases) used the former drugs. All patients were assessed using the Positive and Negative Symptom Scales (PANSS), and the Treatment Emergent Symptom Scale (TESS) was used to assess adverse drug reactions. The Hospitalised Psychiatric Patients' Social Functions Rating Scale (SSPI) was used to assess social function of participants before and after 8 weeks, 6 months and 1 year of treatment.
At baseline there were no significant differences between the two groups in age, duration of illness, educational background and dosage of antipsychotic drugs (converted into chlorpromazine equivalency). There was statistically significant difference in PANSS positive symptoms by interaction effect (F=18.24, df=3237, <0.001) and time effect (F=21.66, df=3, <0.01) and the difference in PANSS positive symptoms by grouping effect (F=0.68, df=1, =0.41) was not statistically significant. The difference of grouping effect of PANSS negative symptoms (F=9.93, df=1, =0.002), time effect (F=279.15, df=3, <0.001) and interaction effect (F =279.15, df=3237, <0.001) were statistically significant. There were statistically significant differences in the grouping effect (F =6.59, df=1, =0.012), time effect (F=152.97, df=3, p<0.001) and interaction effect (F =148.82, df=3237, <0.001) of PANSS general pathological symptoms, the same as the total score of the PANSS, which showed large differences in grouping effect (F =7.04, df=1, =0.001), time effect (F=210.78, df=3, <0.001) and interaction effect (F =205.20, df=3237, <0.01). We found in the total SSPI score, grouping effect (F=31.70, df=1, <0.001), time effect (F=161.84, df=3, <0.001) and interaction effect (F =132.74, df=3237, <0.001) were demonstrated to be significantly different. Even though adverse reactions occurred 7 times in the treatment group and 44 times in the control group based on the Treatment Emergent Symptom Scale (TESS), incidence rate was significantly lower than that of the control group (χ²=18.854, <0.001).
Paliperidone can safely and effectively improve negative symptoms and social function in patients with chronic schizophrenia.
社会功能损害在慢性精神分裂症患者中普遍存在，严重影响家庭、生活和工作状况。
本研究的主要目的是探讨帕利哌酮治疗慢性精神分裂症患者社会功能的疗效。
选取81例符合精神分裂症标准且长期住院的患者，进行为期1年的前瞻性随访研究，随机分为治疗组和正常对照组。治疗组（41例）在原治疗方案基础上酌情使用帕利哌酮缓释片减药；对照组（40例）使用原药物。所有患者均采用阳性与阴性症状量表（PANSS）进行评估，采用治疗中出现的症状量表（TESS）评估药物不良反应。使用住院精神病人社会功能评定量表（SSPI）在治疗8周、6个月和1年后评估参与者的社会功能。
基线时，两组在年龄、病程、教育背景和抗精神病药物剂量（换算为氯丙嗪等效剂量）方面无显著差异。PANSS阳性症状的交互效应（F = 18.24，自由度 = 3237，< 0.001）和时间效应（F = 21.66，自由度 = 3，< 0.01）有统计学显著差异，分组效应（F = 0.68，自由度 = 1，P = 0.41）导致的PANSS阳性症状差异无统计学意义。PANSS阴性症状的分组效应（F = 9.93，自由度 = 1，P = 0.002）、时间效应（F = 279.15，自由度 = 3，< 0.001）和交互效应（F = 279.15，自由度 = 3237，< 0.001）有统计学显著差异。PANSS一般病理症状的分组效应（F = 6.59，自由度 = 1，P = 0.012）、时间效应（F = 152.97，自由度 = 3，P < 0.001）和交互效应（F = 148.82，自由度 = 3237，< 0.001）有统计学显著差异，与PANSS总分情况相同，分组效应（F = 7.04，自由度 = 1，P = 0.001）、时间效应（F = 210.78，自由度 = 3，< 0.001）和交互效应（F = 205.20，自由度 = 3237，< 0.01）差异较大。我们发现，在SSPI总分方面，分组效应（F = 31.70，自由度 = 1，< 0.001）、时间效应（F = 161.84，自由度 = 3，< 0.001）和交互效应（F = 132.74，自由度 = 3237，< 0.001）显示出显著差异。根据治疗中出现的症状量表（TESS），治疗组出现不良反应7次，对照组出现44次，治疗组发生率显著低于对照组（χ² = 18.854，< 0.001）。
帕利哌酮可安全有效地改善慢性精神分裂症患者的阴性症状和社会功能。
