地域で生活する統合失調症患者のメタボリックシンドローム発症に関連する要因の検討 : 生活習慣病の予防に焦点をあてて  [in Japanese] Analysis of Relevant Factors of Metabolic Syndrome among Persons with Schizophrenia Living in Community : Shedding Light on Prevention of Lifestyle-related Diseases  [in Japanese]

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Abstract

本研究の目的は,地域で生活する統合失調症患者のメタボリックシンドローム(以下,MS)発症に関連する要因の検討であった.対象者はA精神科病院を定期的に通院する18歳以上の統合失調症圏内で,支援を受ければ自記式調査票に答えられる人であった.MS状態の評価については血液検査や身体計測を実施し,生活状況および身体活動量などは筆者作成の調査票を用いた.精神機能評価や抗精神病薬に関する患者情報は,主治医より提供を受けた.分析にはSPSS15.0を用い,単純集計,t検定,χ^2検定,多重ロジスティック回帰分析を実施した.結果は,有効数男性191人,女性144人で,平均年齢は男性43.8歳,女性44.6歳であった.MS発症率は全体では22.1%,男性27.2%,女性15.3%で,ともに一般成人より有意に高かった.MS発症に関連する要因の検討では,全体と男性では「BMI」と「喫煙の傾向」がMS発症頻度を増加させ,「洗濯をする」がMS発症頻度を減少させた.女性では「BMI」がMS発症頻度を増加させ,「リスペリドン服用」がMS発症頻度を減少させる結果であった.実践への示唆として,腹部肥満の改善,家事の実行,喫煙の改善,抗精神病薬による影響のモニタリングが挙げられた.

The purpose of this study was to examine the prevalence of metabolic syndrome (MS) among community dwelling persons with schizophrenia and its relevant factors. Subjects were adults with schizophrenia regularly receiving treatment at A-hospital psychiatric out-patient clinic. Inclusion criteria for participation were: age 18 years or older; disease category F20-F29 based on ICD-10 diagnostic criteria; and able to answer the questionnaire with support. To assess metabolic syndrome status, blood samples and body measurements were obtained at the clinic. Physicians provided information about psychiatric symptoms of a 1-100 point scale based on DSM-IV Japanese version and medications. To assess both daily activities such as those related to housekeeping and physical activity related to exercise. t-test, chisquare test, and multivariate logistic regression analysis were used to describe the results. Statistical analysis was done using SPSS (ver. 15.0). Usable data were provided by 191 men and 144 women (mean 43.8 and 44.6 years). According to the 2005 Japanese diagnostic criteria for MS, it was clinically very significant that MS was more prevalent among community dwelling persons with schizophrenia (22.1%; men 27.2% and women 15.3%) than in the general public in Japan (7.8%; men 12.1% and women 1.7%). Logistic regression analysis with MS as a binary variable identified the following factors as related to MS for the total and the men's sample: high body mass index and smoking; however, washing showed a statistically significant negative association to MS. Among women body mass index was strongly related to MS; however, taking resperidone showed a statistically significant negative association to MS. The data from this study provided evidence that decrease visceral obesity, promote engaging in domestic duties, reduce smoking, and regular monitoring of metabolic risks associated with antipsychotic treatment.

Journal

  • Journal of Japan Academy of Psychiatric and Mental Health Nursing

    Journal of Japan Academy of Psychiatric and Mental Health Nursing 19(1), 44-54, 2010

    The Japan Academy of Psychiatric and Mental Health Nursing

References:  27

Codes

  • NII Article ID (NAID)
    110008727628
  • NII NACSIS-CAT ID (NCID)
    AN10478677
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    0918-0621
  • NDL Article ID
    10757645
  • NDL Source Classification
    ZS47(科学技術--医学--治療医学・看護学・漢方医学)
  • NDL Call No.
    Z19-3804
  • Data Source
    CJP  NDL  NII-ELS  J-STAGE 
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