Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland.
Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland.
Compr Psychiatry. 2022 May;115:152307. doi: 10.1016/j.comppsych.2022.152307. Epub 2022 Mar 12.
Up to 50% of patients with schizophrenia are suffering from motor abnormalities, which may contribute to decreased quality of life, impaired work capacity, and a reduced life expectancy by 10-20 years. However, the effect of motor abnormalities on social and global functioning, as well as, functional capacity is not clear. We hypothesized, that the presence of motor abnormalities is associated with poorer functional outcomes in patients with schizophrenia.
We collected data on 5 different motor abnormalities in 156 patients suffering from schizophrenia spectrum disorders: parkinsonism, catatonia, dyskinesia, neurological soft signs and psychomotor slowing (PS). Additionally, we used three different scales to evaluate the functional outcomes in these patients: the Global Assessment of Functioning (GAF) and the Social and Occupational Functioning Assessment Scale (SOFAS) which use clinicians' judgment; and one using a performance-based measure of functional capacity, the brief version of the UCSD Performance-based Skills Assessment (UPSA-B).
Our analysis demonstrated that patients with catatonia (all F > 4.5; p < 0.035) and parkinsonism (all F > 4.9; p < 0.027) scored lower on GAF and SOFAS compared to patients without catatonia and parkinsonism. In contrast, no significant difference on functional outcomes between patients with dyskinesia versus without dyskinesia exist in our study. Furthermore, there are statistically significant negative correlations for parkinsonism and PS with GAF, SOFAS and UPSA-B (all tau are at least -0.152, p-value <0.036). We also found significant negative correlations between catatonia and both GAF & SOFAS (all tau are at least -0.203, p-value<0.001) and between NES and SOFAS (tau = -0.137, p-value = 0.033).
Here, we showed that four of the most common motor abnormalities observed in schizophrenia were associated with at least one of the patients' functional outcomes. The stronger the motor impairment was the worse the global and social functioning. Future studies need to test, whether amelioration of motor abnormalities is linked to improved community functioning.
多达 50%的精神分裂症患者存在运动异常，这可能导致生活质量下降、工作能力受损以及预期寿命缩短 10-20 年。然而，运动异常对社会和整体功能以及功能能力的影响尚不清楚。我们假设，精神分裂症患者存在运动异常与较差的功能结果有关。
我们收集了 156 名患有精神分裂症谱系障碍的患者的 5 种不同运动异常的数据：帕金森病、紧张症、运动障碍、神经软体征和精神运动迟缓（PS）。此外，我们使用了三种不同的量表来评估这些患者的功能结果：使用临床医生判断的总体功能评估（GAF）和社会和职业功能评估量表（SOFAS）；以及使用基于表现的功能能力测量的简短版 UCSD 基于表现的技能评估（UPSA-B）。
我们的分析表明，患有紧张症（所有 F>4.5；p<0.035）和帕金森病（所有 F>4.9；p<0.027）的患者在 GAF 和 SOFAS 上的评分低于没有紧张症和帕金森病的患者。相比之下，我们的研究中，患有运动障碍的患者与没有运动障碍的患者在功能结果方面没有显著差异。此外，帕金森病和 PS 与 GAF、SOFAS 和 UPSA-B 之间存在统计学上显著的负相关（所有 tau 至少为-0.152，p 值<0.036）。我们还发现紧张症与 GAF 和 SOFAS 之间存在显著的负相关（所有 tau 至少为-0.203，p 值<0.001），以及神经软体征与 SOFAS 之间存在显著的负相关（tau=-0.137，p 值=0.033）。
在这里，我们表明精神分裂症中观察到的四种最常见的运动异常至少与患者的一种功能结果有关。运动障碍越严重，整体和社会功能越差。未来的研究需要测试改善运动异常是否与改善社区功能有关。
