精神分裂症患者临床医生依从指南推荐治疗与记忆功能之间的关系

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2025-03-27 DOI:10.1016/j.jpsychires.2025.03.054

Yasushi Kawamata , Kazutaka Ohi , Satsuki Ito , Naomi Hasegawa , Yuka Yasuda , Michiko Fujimoto , Hidenaga Yamamori , Kentaro Fukumoto , Fumitoshi Kodaka , Junya Matsumoto , Norio Yasui-Furukori , Ryota Hashimoto

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引用次数: 0

摘要

精神分裂症患者的记忆功能损伤严重，但改善记忆功能仍然具有挑战性。精神分裂症药物治疗指南不推荐使用苯二氮卓类药物和抗胆碱能药物，它们与认知功能恶化有关。然而，尚不清楚精神科医生对精神分裂症药物治疗指南的更好遵守是否与改善记忆功能有关。因此，我们调查精神分裂症患者精神科医生依从性与记忆功能的关系。方法为了评估精神科医生对药物治疗指南的依从性与记忆功能之间的关系，我们使用了包含多个质量指标的个体健康评分（IFS）来评估每位精神科医生在治疗每位患者时对这些指南的依从性。采用韦氏记忆量表对351例患者进行记忆功能测试，其中40例为难治性精神分裂症（TRS）， 311例为非难治性精神分裂症（non-TRS）。结果精神分裂症患者的精神科依从性与言语记忆（β = 0.145, p = 6.45 × 10−3）、注意力/注意力（β = 0.138, p = 0.010）和延迟回忆（β = 0.167, p = 1.57 × 10−3）呈显著正相关。此外，与视觉记忆有名义上的正相关（β = 0.124, p = 0.019）。在非trs患者中，精神科医生的依从性与延迟回忆（β = 0.166, p = 3.17 × 10−3）呈显著正相关，与言语记忆（β = 0.141, p = 0.013）和注意力/集中（β = 0.114, p = 0.044）功能呈名义正相关。相比之下，没有观察到精神科医生的依从性与TRS患者的任何记忆功能之间的显著关联。结论加强精神科医师指南教育可改善精神分裂症患者的认知障碍。

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Relationships between clinician adherence to guideline-recommended treatment and memory function in patients with schizophrenia

Background

Memory function impairment is severe in patients with schizophrenia, but improving memory function remains challenging. The use of benzodiazepines and anticholinergics, which are not recommended by pharmacological therapy guidelines for schizophrenia, has been associated with worsened cognitive function. However, it remains unclear whether better adherence by psychiatrists to pharmacological therapy guidelines for schizophrenia is associated with improved memory function. Therefore, we investigated the relationship between psychiatrists’ adherence and memory function in patients with schizophrenia.

Methods

To evaluate the associations between psychiatrists' adherence to pharmacological therapy guidelines and memory function, we utilized the Individual Fitness Score (IFS), which includes multiple quality indicators, to assess each psychiatrist's adherence to these guidelines in treating each patient. Memory function was measured using the Wechsler Memory Scale-Revised in a total of 351 patients, including 40 patients with treatment-resistant schizophrenia (TRS) and 311 patients with non-TRS.

Results

We found that psychiatrist adherence was significantly positively correlated with verbal memory (β = 0.145, p = 6.45 × 10⁻³), attention/concentration (β = 0.138, p = 0.010), and delayed recall (β = 0.167, p = 1.57 × 10⁻³) in all patients with schizophrenia. Additionally, a nominal positive correlation was observed with visual memory (β = 0.124, p = 0.019). In non-TRS patients, the adherence of psychiatrists was significantly positively correlated with delayed recall (β = 0.166, p = 3.17 × 10⁻³) and nominally positively correlated with verbal memory (β = 0.141, p = 0.013) and attention/concentration (β = 0.114, p = 0.044) functions. In contrast, no significant associations were observed between the psychiatrists’ adherence and any memory functions in patients with TRS.

Conclusions

These findings suggest that enhancing guideline education for psychiatrists might improve cognitive impairments in patients with schizophrenia.

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来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;