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精神分裂症患者的认知轨迹和痴呆风险与情感障碍对比
Kathy Y Liu1, Gayan Perera2, Robert Howard1
1Division of Psychiatry, University College London, London, UK.
Psychological medicine
|September 30, 2025
概括
患有精神分裂症谱系障碍的人比患有情感障碍的人更早地经历认知衰退,导致早期的痴呆症诊断. 针对性地预防老年痴呆症和公平的治疗机会对这一群体至关重要.
科学领域:
- 老年精神病学是一门精神病学专业.
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
背景情况:
- 精神分裂症谱系障碍与痴呆症风险增加有关.
- 与情绪障碍相比,精神分裂症谱系障碍的认知衰退的确切时间和进展尚不清楚.
研究的目的:
- 将被诊断为精神分裂症谱系障碍和原发性情绪障碍的患者之间的认知轨迹和痴呆风险进行比较.
- 分析这些患者群体认知衰退的时间,痴呆症诊断和治疗模式.
主要方法:
- 进行了对非识别电子病例记录的回顾性分析.
- 认知轨迹的评估是使用微型心理状态检查 (MMSE) 评分,从至少两个记录的评估分隔至少六个月.
- 精神分裂症谱系和情感障碍队列之间的痴呆风险,亚型和治疗率进行了比较.
主要成果:
- 与情感障碍患者 (平均年龄为71.1岁) 相比,精神分裂症谱系障碍患者 (平均年龄为65.0岁) 显示出较早的初始MMSE得分 (6.1年前) 和痴呆症诊断 (2.3年前).
- 尽管早些时候诊断出精神分裂症,但精神分裂症谱系障碍的调整后痴呆风险较低 (HR=0.81).
- 认知能力下降率和痴呆症亚型没有差异,但精神分裂症患者在痴呆症诊断中出现了较长的延迟 (5.6与4.4年相比),并且不太可能接受抗痴呆药物治疗.
结论:
- 在精神分裂症谱系障碍患者中,认知问题在63岁左右出现,比起情感障碍,早期的痴呆症诊断更早.
- 这些发现强调了需要针对精神分裂症谱系障碍患者制定主动性痴呆症预防和治疗策略的需要.
- 迫切需要解决这一群体在获得痴呆症评估和治疗服务方面的不平等问题.
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