Davidson M, Harvey P D, Powchik P, Parrella M, White L, Knobler H Y, Losonczy M F, Keefe R S, Katz S, Frecska E
Department of Psychiatry, Mount Sinai School of Medicine, New York.
Am J Psychiatry. 1995 Feb;152(2):197-207. doi: 10.1176/ajp.152.2.197.
The goal of this study was to characterize the symptoms of geriatric, chronically ill, institutionalized schizophrenic patients and investigate age-related differences in schizophrenic symptoms and cognitive performance from early adulthood to late senescence.
The Positive and Negative Syndrome Scale and the Mini-Mental State examination were used to assess the schizophrenic symptoms and cognitive performance, respectively, of 393 institutionalized schizophrenic patients stratified into seven groups designated by 10-year age intervals from 25 years to over 85 years.
In the comparisons of the seven age groups, significant differences between groups in positive and negative subscale scores on the Positive and Negative Syndrome Scale and in Mini-Mental State scores were revealed. Significant correlations between Mini-Mental State scores and Positive and Negative Syndrome Scale negative symptom scores, but not positive symptom scores, were found for all age groups, except for the youngest patients studied. Current treatment with neuroleptics and prior treatment with ECT, insulin coma, or leukotomy could not account for the poor cognitive performance of the older schizophrenic patients.
The older schizophrenic patients continued to experience psychotic and nonpsychotic symptoms in senescence. Their positive symptoms were moderately less severe and their negative symptoms and cognitive impairment were significantly more severe than those of the younger patients. Somatic treatment appeared not to be responsible for the severe cognitive impairment and negative symptoms of the older patients. These data are relevant to chronically hospitalized geriatric schizophrenic patients but not necessarily to all geriatric schizophrenic patients.
本研究的目的是描述老年慢性患病、住院治疗的精神分裂症患者的症状，并调查从成年早期到老年期精神分裂症症状和认知表现的年龄相关差异。
使用阳性与阴性症状量表和简易精神状态检查表，分别评估393名住院治疗的精神分裂症患者的精神分裂症症状和认知表现，这些患者被分为七组，按10岁年龄间隔划分，从25岁到85岁以上。
在七个年龄组的比较中，阳性与阴性症状量表的阳性和阴性分量表得分以及简易精神状态检查表得分在组间存在显著差异。除了所研究的最年轻患者外，在所有年龄组中均发现简易精神状态检查表得分与阳性与阴性症状量表阴性症状得分之间存在显著相关性，但与阳性症状得分无关。目前使用抗精神病药物治疗以及既往使用电休克治疗、胰岛素昏迷治疗或脑白质切断术治疗均不能解释老年精神分裂症患者认知表现不佳的原因。
老年精神分裂症患者在老年期仍会出现精神病性和非精神病性症状。他们的阳性症状严重程度略低，而阴性症状和认知障碍比年轻患者明显更严重。躯体治疗似乎不是老年患者严重认知障碍和阴性症状的原因。这些数据与长期住院的老年精神分裂症患者相关，但不一定适用于所有老年精神分裂症患者。
