Ji Ziyang, Yao Fengju, Liu Hanxiao, Zhang Yixuan, Lei Qinlin, Li Haoxue, Dong Jiao, Gu Jingyang, Wang Changhong
Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, 453003, China.
Henan Collaborative Innovation Center of Prevention and treatment of mental disorder, Xinxiang, Henan Province, 453003, China.
BMC Psychiatry. 2025 Aug 26;25(1):819. doi: 10.1186/s12888-025-07297-y.
Cognitive dysfunction is a core characteristic of schizophrenia, independent of positive and negative symptoms. It significantly impacts social reintegration, quality of life, and imposes a burden on families and society. This study investigates the prevalence and influencing factors of cognitive impairment in patients with stable schizophrenia on regular medication, with the hope of providing assistance to the cognitive improvement of patients.
A multistage stratified sampling approach was implemented to screen and enroll eligible patients with stable schizophrenia from five specialized psychiatric hospitals in Henan Province. Psychiatrists who had received standardized training conducted questionnaire responses and cognitive assessments for the patients, and quality control personnel reviewed the questionnaires. Binary Logistic analysis was used to detect the influencing factors of cognitive function.
The valid questionnaires of 1,274 patients were collected from January 1, 2022, to December 31, 2023. The cognitive dysfunction rate of the patients with stable schizophrenia on regular medication was 66.2%. The risk factors for cognitive function, in descending order, are: first-generation antipsychotics (FGAs) (: 9.246, : 1.021,1.093), family history (: 2.535, : 1.349,4.762), negative symptoms (: 2.532, : 1.735,3.695), mood stabilizers (: 1.882, : 1.356,2.613), anticholinergic drugs (: 1.616, : 1.161,2.249), combined medication (: 1.332, : 1.009,1.760), high body mass index (BMI) (: 1.069, : 1.030,1.111), longer duration of education (: 1.057, : 1.021,1.093), and long duration of disease (: 1.045, : 1.028,1.063). The protective factors, in descending order, are: taking 5-HT1A receptor partial agonist (: 0.657, : 0.503,0.857) and having more children (: 0.817, : 0.732,0.912). The sensitivity of the regression model for predicting cognitive function was 66.5%, and the specificity was 88.0%.
Findings highlight the complex interplay of personal, familial, psychiatric, physical, and pharmacological factors in cognitive impairment. Medication use, especially FGAs, significantly influences cognitive function, underscoring the need for psychiatrists to closely monitor treatment regimens to mitigate cognitive decline and improve long-term outcomes in patients with stable schizophrenia.
The online version contains supplementary material available at 10.1186/s12888-025-07297-y.
认知功能障碍是精神分裂症的核心特征，与阳性和阴性症状无关。它对社会重新融入、生活质量有显著影响，并给家庭和社会带来负担。本研究调查规律服药的稳定期精神分裂症患者认知障碍的患病率及影响因素，以期为患者的认知改善提供帮助。
采用多阶段分层抽样方法，从河南省五家精神专科医院筛选并纳入符合条件的稳定期精神分裂症患者。接受过标准化培训的精神科医生对患者进行问卷调查和认知评估，质量控制人员对问卷进行审核。采用二元Logistic分析检测认知功能的影响因素。
收集了2022年1月1日至2023年12月31日期间1274例患者的有效问卷。规律服药的稳定期精神分裂症患者认知功能障碍率为66.2%。认知功能的危险因素，按影响程度降序排列为：第一代抗精神病药物（FGA）（：9.246，：1.021，1.093）、家族史（：2.535，：1.349，4.762）、阴性症状（：2.532，：1.735，3.695）、心境稳定剂（：1.882，：1.356，2.613）、抗胆碱能药物（：1.616，：1.161，2.249）、联合用药（：1.332，：1.009，1.760）、高体重指数（BMI）（：1.069，：1.030，1.111）、受教育时间较长（：1.057，：1.021，1.093）、病程较长（：1.045，：1.028，1.063）。保护因素，按影响程度降序排列为：服用5-HT1A受体部分激动剂（：0.657，：0.503，0.857）和子女较多（：0.817，：0.732，0.912）。预测认知功能的回归模型的敏感性为66.5%，特异性为88.0%。
研究结果突出了个人、家族、精神、身体和药物因素在认知障碍中的复杂相互作用。药物使用，尤其是第一代抗精神病药物，对认知功能有显著影响，强调精神科医生需要密切监测治疗方案，以减轻认知功能衰退，改善稳定期精神分裂症患者的长期预后。
在线版本包含可在10.1186/s12888-025-07297-y获取的补充材料。
