精神分裂症未治期前驱症状及影响因素分析

目的了解精神分裂症患者未治疗期间（DUP）前驱症状及其家庭因素的影响。方法应用诺丁汉起病症状量表（NOS）调查卢湾区精神卫生中心的精神分裂症患者，共收集59例。同时，应用家庭问卷对患者家属进行访谈，调查可能影响患者及时就诊的因素。结果（1）精神分裂症患者DUP中位数是465d；（2）首发非特异性精神症状以猜疑和行为障碍最为常见，出现频度超过24％；首发精神病性症状以妄想和幻听最为常见，出现频度达到58％；（3）影响患者就诊的主要因素是家属希望患者自己恢复和患者不愿接受治疗；（4）以DUP中位数465d将患者区分为长DUP组和短DUP组，发现：短DUP家属组（DUP≤465的）在思维中的奇怪观念和魔术性思维的比例显著高于长DUP组（χ2=14.75，P=0.0001；χ2=4.54，P=0.033）。结论精神分裂症患者从发病到开始治疗的疾病未治疗期间较长，患者的思维障碍促进患者家属积极寻求治疗。

Analysis on prodromas and factors involved in schizophrenia in duration of untreated psychosis

Objective To evaluate prodromas and factors involved in schizophrenia in the duration of untreated psychosis （DUP）. Methods DUP were evaluated among 59 schizophrenia patients with Nottingham Onset Schedule （NOS）. The factors involved in schizophrenia were investigated by interviewing the relatives of patients with a self--made scale. Results The median DUP were 465 days. The most common prodmmal symptoms were suspicious and behavior disorders. The most common first psychotic symptoms were auditory hallucinations and delusion. Factors interfering the patient＇s diagnosis and management were the family ignorance of the disease and the reluctance of the patients to receive medical care. More patients with shorter DUP represented odd concept and magical thought （X^2 = 14.75, P = 0.0 001 ; X^2 =4.54, P = 0. 033）. Conclusions The duration of untreated illness is much longer in schizophrenia.