長期入院中統合失調症患者における抗精神病薬・抗コリン薬慢性投与の認知機能・症状・生活の質に及ぼす影響

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長期入院中統合失調症患者における抗精神病薬及び抗コリン薬の慢性投与が認知機能・症状・生活の質に及ぼす影響を検討するため，各評価尺度と抗精神病薬haloperidol（HPD）換算量及び抗コリン薬biperiden（BPD）換算量との関連性を検討した。各評価尺度として，Hasegawa Dementia Scale-Revised（HDS-R），Brief Psychiatric Rating Scale（BPRS），The Schizophrenia Quality of Life Scale, a Japanese version（JSQLS）を用いた。定型抗精神病薬（定型薬）のみ処方群と非定型抗精神病薬（非定型薬）のみ処方群の間でのBPRS下位項目（陽性症状，陰性症状，気分変調，躁症状）得点における有意差，定型薬HPD換算量・抗コリン薬BPD換算量のJSQLS下位項目（心理社会関係の障害，動機・活力の低下）に対する相関性が認められた。以上から，精神症状遷延化症例において，定型薬処方継続の傾向が示唆され，加えて定型薬及び抗コリン薬投与の固定化は，慢性期の統合失調症患者に対し自立や社会復帰において負の影響を与える可能性が高いことが示唆された。We examined the effects of chronic treatments using antipsychotics and cholinergic agents for long-stay schizophrenic inpatients with reference to their cognitive functions, psychiatric symptoms, and their quality of life. Hasegawa Dementia Scale-Revised (HDS-R), Brief Psychiatric Rating Scale (BPRS), The Schizophrenia Quality of Life Scale, and a Japanese version (JSQLS) were used as each measure for evaluation of their cognitive functions, psychiatric symptoms, and their quality of life. In addition, we examined the correlation between amount of antipsychotics or anticholinergic agents per one patient and each measure for the above-mentioned evaluation. The results showed that there was a significant correlation between amount of typical antipsychotics or anticholinergic agents and quality of life. Furthermore, there was significant difference in BPRS score between patients administered typical antipsychotics and patients administered atypical antipsychotics. In conclusion, the results suggest the tendency to continue the same prescription of typical antipsychotic in the patients whose symptoms do not improve easily. In addition, the results suggest that long-term administration of typical antipsychotics and anticholinergic agents has a negative influence on independence and rehabilitation into society in patients with schizophrenia of the chronic phase.原著Original Articles
県立広島大学の論文

長期入院中統合失調症患者における抗精神病薬・抗コリン薬慢性投与の認知機能・症状・生活の質に及ぼす影響

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