【摘要】 目的:探讨苯丙胺类兴奋剂所致精神障碍首次发病(以下简称为首发)患者治疗前后认知功能的变化。方法:对80例符合中国精神障碍分类与诊断标准第3版的物质依赖诊断标准的苯丙胺类兴奋剂所致精神障碍首发患者为研究组,给予利培酮(40例,4~6mg/d)或奥氮平(40例,10~20mg/d)治疗,共12周。于治疗基线和治疗末评定18项简明精神病量表(BPRS18)、韦氏记忆量表、连续操作测验、威斯康星卡片分类测验,并与80名健康志愿者为对照组比较。结果:①治疗后,研究组患者的神经心理学测验成绩较治疗前均明显提高(P<0.05或P<0.01)。②研究组患者正确应答数与思维障碍分呈负相关(r=-0.26,P=0.021),记忆商数与焦虑抑郁分呈负相关(r=-0.27,P=0.017),短时记忆与缺乏活力分呈负相关(r=-0.34,P=0.002)。③治疗后,研究组患者的总应答数、持续错误数、随机错误数均高于对照组(P<0.05),记忆商数、长时记忆、短时记忆均低于对照组(P<0.05)。结论:苯丙胺类兴奋剂所致精神障碍首发患者治疗后认知功能明显提高,认知障碍改善与临床症状缓解存在相关性,治疗后仍有部分患者的认知功能未恢复到正常水平。更多还原

【Abstract】 Objective: To explore difference of cognitive function of patients with first-episode mental disorders due to amphetamine-type stimulants before and after treatment. Methods: Eighty patients with first-episode mental disorders due to amphetamine-type stimulants meeting the diagnostic criteria of mental disorders-3( research group) were given extended releasing risperidone( 40 cases,4-6mg /d) or olanzapine( 40 cases,10-20mg /d) treatment for 12 weeks,and eighty healthy people( control group) were involved as controls. The illness severity was assessed with the 18-item brief psychiatric rating scale( BPRS),and cognition function was evaluated with a series of neuropsychological tests including the Wechsler memory scale,continuous performance test and Wisconsin cards sorting test before and after the treatment. Results:( 1) The research group made improvements in the neuropsychological tests after the treatment( P < 0. 05 or < 0. 01).( 2) The correct responses of research group were negatively correlated with thought disorder score( r =-0. 26,P = 0. 021),memory quotient was negatively correlated with anxiety depression score( r =-0. 27,P = 0. 017),and short-term memory was negatively correlated with lack of energy score( r =-0. 34,P = 0. 002).( 3) In comparison with those of control group,after the treatment,research group still had higher scores of total responses,preservative errors,random errors( P < 0. 05),and had lower scores of memory quotient,long-term memory,and short-term memory( P < 0.05). Conclusions: After the treatment,the cognitive function is improved for the patients with first-episode mental disorders due to amphetamine-type stimulants,and it is correlated with the symptom alleviation; however,a portion of the patients still have cognitive function impairment even after the treatment.更多还原