[[alternative]]A Correlation Study between Swallowing Problems of Patients with Chronic Schizophrenia and Antipsychotics, Cognitive Function and Movement Disorders.

[[abstract]]本研究以西北吞嚥障礙篩檢表（Northwestern Dysphagia Patient Check Sheet; NDPCS）了解慢性精神分裂症患者吞嚥問題的百分比與症狀，探討精神分裂患者使用抗精神藥物在認知功能與運動障礙上的差異性，並分析精神分裂患者的人口學、抗精神藥物、認知功能與運動障礙在吞嚥障礙篩檢的結果上是否有差異，以及探究吞嚥困難的預測因子。研究對象為中部某精神專科醫院慢性病房之精神分裂症患者，符合收案條件的個案共93名，分別接受認知功能、運動障礙評估以及吞嚥障礙篩檢。所得資料以次數分配表、百分比、平均值、標準差、卡方檢定、獨立樣本t檢定、單因子變異數分析與多元迴歸等分析。研究結果發現，（1）慢性精神分裂症患者吞嚥困難百分比為30.10%；（2）有吞嚥問題的精神分裂症患者常見的吞嚥障礙症狀為口腔殘留（96.4%）、多次吞嚥（71.7%）與喉上抬不足（60.7%）；（3）精神分裂患者使用抗精神藥物的種類與劑量在認知功能表現與運動障礙上無顯著差異；（4）有吞嚥困難的患者年齡較大、抗精神病藥物的劑量較低、認知功能、遲發性運動障礙與巴金森氏症候群較嚴重；（5）吞嚥問題的預測因子為雙唇和口周圍部位的遲發性運動障礙與巴金森氏症候群。本研究結果可以提供給相關專業人員做為參考，給予患者適切的評估與建議以提供完整的後續照護。[[abstract]]The purposes of this study were to investigate the percentage and symptom of swallowing problem in schizophrenia patients with Northwestern Dysphasia Patient Check Sheet (NDPCS), to examine the differences of cognitive function and movement disorders in using antipsychotics, and to analyze the correlation among demography, antipsychotics, cognitive and movement disorders in schizophrenic patients with dysphasia. Ninety three patients with schizophrenia were recruited from chronic psychiatric ward at Taichung cities. They were examined the NDPCS, cognitive function and movement disorders. Data that appropriate for inclusion were analyzed with frequency distribution table, percentage, mean, standard deviation, chi-square test, independent sample t-test, ANOVA analysis and multivariate logistic regression.The results showed that (1) about 30 percentage of patients with chronic schizophrenia are dysphasia; (2) dysphasia patients with schizophrenia have common symptoms of swallowing problems, including oral residue (96.4%), multiple swallowing per bolus (71.7%) and lack of laryngeal elevation (60.7%); (3) there is no significant difference between cognitive function and movement disorders by using different dosage and kind of antipsychotics in patients with schizophrenia; (4) dysphasia patients are more elder, lower doses of antipsychotics, poor cognitive function, severe in tardive dyskinesia, and Parkinson's syndrome; (5) the predictors of swallowing problems are tardive dyskinesia of the lips and around the mouth and Parkinson's syndrome. The results of this study could provide a guideline for varying professionals and give appropriate evaluation and recommendation to patient for provide comprehension intervention