Long-term course of cognitive function in chronically hospitalized patients with schizophrenia transitioning to community-based living
Long-term course of cognitive function in chronically hospitalized patients with schizophrenia transitioning to community-based living
复制标题
DOI：
10.1016/j.schres.2014.03.015
复制
发表时间：
2014-05
影响因子：
4.5
通讯作者：
T. Nemoto;Hidehito Niimura;Y. Ryu;Kei Sakuma;M. Mizuno
中科院分区：
文献类型：
--
作者：
T. Nemoto;Hidehito Niimura;Y. Ryu;Kei Sakuma;M. Mizuno
精神分裂症与社会交往障碍有关，患者生活和接受治疗的条件似乎在疾病过程中起着重要作用。然而，护理环境对认知过程的影响仍然存在争议。关闭精神病医院和向社区生活过渡是解决这一问题的一个黄金机会。本研究的目的是检查（1）长期住院然后出院的精神分裂症患者的认知纵向过程以及精神病理学和社会功能，以及（2）此类患者功能结局的关键认知预测因素。在一家精神病医院关闭后，78名病人被转移到社区。这些患者接受了5年的随访，并接受了年度检查，包括认知、精神症状和社会功能的测量。五十六例患者完成了所有评估。虽然在注意力和记忆的认知领域显示出持续的改善，但整体认知和处理速度的最初改善最终开始下降。在随访期间，症状和整体功能几乎一致改善。逐步多元回归显示，类别流畅性在基线预测社会功能在5年。然而，这种相关性不再显着时，精神病理学变量作为预测因素。这些结果表明，护理环境会影响认知过程，解决这些问题可能会导致一定程度的认知改善，即使是长期住院的精神分裂症患者。
Schizophrenia is associated with impairments in social interactions, and the conditions under which patients live and undergo treatment appear to have an important role in the course of the disease. However, the influences of care settings on the course of cognition remain controversial. The closure of psychiatric hospitals and the transition to community-based living is a golden opportunity to address this issue. The aims of the present study were to examine (1) the longitudinal course of cognition as well as the psychopathology and social functioning of schizophrenia patients who had been chronically hospitalized and then discharged, and (2) the key cognitive predictors of the functional outcome of such patients. Seventy-eight patients were transferred to the community after the closure of a psychiatric hospital. These patients were followed-up for 5 years and underwent annual examinations that included measures of cognition, psychiatric symptoms, and social functioning. Fifty-six patients completed all the assessments. Although consistent improvements were shown in the cognitive domains for attention and memory, the initial improvements in global cognition and processing speed ultimately began to decline. Symptoms and global functioning improved almost consistently over the course of the follow-up period. Stepwise multiple regressions revealed category fluency at baseline predicted social functioning at 5 years. However, this correlation was no longer significant when psychopathological variables were included as predictors. These results suggest that care settings affect the course of cognition, and addressing these conditions may lead to a certain degree of cognitive improvement even among schizophrenia patients who have been chronically institutionalized.