統合失調症長期入院患者の認知機能障害—外来患者との比較

Neurocognitive dysfunction of long-term hospitalization of patients with schizophrenia: A comparison with outpatients

要旨：本研究の目的は，統合失調症長期入院患者の認知機能障害を，外来（デイケア）患者との比較によって明らかにすることである．入院群（n＝33）は外来群（n＝30）より，年齢，累積入院期間，服薬量，簡易版陽性・陰性症状評価尺度（Brief PANSS）の妄想が有意に高く，機能の全体的評定尺度（GAF）と統合失調症認知機能簡易評価尺度日本語版（BACS）の言語性記憶，ワーキングメモリ，運動機能，注意と処理速度，遂行機能，総合点が有意に低かった．入院群の認知機能障害には，長期入院や慢性経過を背景とする全般的な心理社会的機能の低下や抗精神病薬服用量などが，関連している可能性が推測された．

　The purpose of this study was to clarify neurocognitive dysfunction of long-term inpatients with schizophrenia by comparing with outpatient (daycare) patients. Long-term hospitalized patients (n=33; hospital group) and outpatients (n=30; foreign group) participated in the study. Patient age, cumulative duration of hospitalization, amount of medication, and occurrence of “delusions” assessed by the Brief Positive and Negative Syndrome Scale (Brief PANSS) were significantly higher in the hospital group than in the foreign group, whereas the Global Assessment of Functioning (GAF), verbal memory, working memory, motor function, attention and processing speed, executive function, and composite score of Brief Assessment of Cognition in Schizophrenia (BACS) were significantly lower. Cognitive dysfunction in hospitalized groups may be associated with long-term hospitalization, or/and a declining psychosocial function caused by the chronic course of schizophrenia, or/and the dose of their antipsychotics.