神经症、心境障碍、精神分裂症患者MMPI测查结果分析

目的探讨神经症、心境障碍、精神分裂症的MMPI调查问卷模式,并剖析三组患者心理特征,以协助临床医师进行诊断和治疗。方法采用病例对照研究,三组304例患者MMPI测试结果进行分析,同时选取100名健康被试进行对照研究。结果神经症与心境障碍患者,各量表分之间无显著差异;心境障碍组和精神分裂症组的各量表T分之间,L／F／Hs／Hy／Mf／Pa／Ma无显著差异,K／D／Pd／Pt／Sc／Si存在显著差异;精神分裂症组在Pt、Sc、Ma和Si,T分有所偏低。结论MMPI在神经症、心境障碍、精神分裂症之间有特异的临床特征和测图模式．     

精神分裂症心理社会危险因素研究

目的探讨精神分裂症患者的心理社会危险因素。方法采用生活事件量表（LES）、社会支持评定量表（SSRS）及防御方式问卷（DSQ）对120例精神分裂症患者（病例组）以及121例正常志愿者（对照组）进行测查,并分析精神分裂症患者的心理社会危险因素。结果精神分裂症患者生活事件总频度和分值以及负性生活事件频度和分值均高于对照组（P〈0.01）,社会支持总分、主观社会支持因子分、客观支持因子分及社会支持利用度因子分均低于对照组（P〈0.01）,更多采用不成熟和中间型防御方式（P〈0.01）。Logistic回归分析显示负性事件总分、社会支持利用度、不成熟防御机制和中间型防御机制是影响精神分裂症发病的重要因素。结论负性生活事件、社会支持利用度、不成熟防御机制及中间型防御方式与精神分裂症的发病密切相关。     

精神分裂症患者凶杀行为多因素分析

目的探讨精神分裂症患者凶杀行为的影响因素。方法应用人口学资料、阳性与阴性症状量表（PANSS）、明尼苏达多相人格调查表（MMPI）、生活事件量表（LES）和社会支持评定量表（SSRs）等对31例具有凶杀行为的精神分裂症患者和50例无凶杀行为的患者进行对照研究。结果两组的PANSS量表阳性症状量表分、阴性症状量表分、MMPI的D（抑郁）、Hy（癔病）、Pd（人格偏移）,Mf（男性化和女性化）、Pa（偏执）、Pt（精神衰弱）、Sc（精神分裂症）、Si（社会内向性）量表分、负性事件刺激量、客观支持量表分等项目得分的差异,有统计学显著意义。多因素分析中,阴性症状,客观支持,D,Mf,Pt,sc进入回归方程。结论本研究提示负性事件、阴性症状、客观支持、D、Mf、Pt、Sc与精神分裂症患者凶杀行为有关联,可作为其预测因子。     

产后抑郁症患者的心理社会因素分析

目的研究产后抑郁症患者的人格特征、生活事件及社会支持影响因素。方法对93例产后抑郁症患者及135名正常产妇分别应用艾森克人格问卷、生活事件量表及社会支持评定量表进行评估。结果与正常产妇相比较,产后抑郁症在人格方面具有内倾及神经质倾向,且常经历较多的负性生活事件;产后抑郁症组的社会支持总分及其各分量表得分均显著低于正常组。结论产后抑郁症的发生与人格、生活事件及社会支持等心理社会因素有关。     

精神分裂症与心境障碍交替发作47例临床分析

目的:探讨精神分裂症和心境障碍交替发作这一特殊病例群体的演变规律和可能的诊断归属问题。方法:在15年间住院3次或以上,诊断为精神分裂症或心境障碍的638例病历中筛选出有精神分裂症和心境障碍诊断变更的81例,按中国精神障碍分类与诊断标准第3版分别再诊断,符合要求者作为研究组,共47例(7.4%)。结果:精神分裂症→心境障碍组36例,最后诊断为精神分裂症14例(38.9%),诊断为心境障碍22例(61.1%);心境障碍→精神分裂症组11例,最后诊断为心境障碍7例(63.6%),精神分裂症4例(36.4%);心境障碍→精神分裂症组的最后诊断与初次诊断的一致率显著高于精神分裂症→心境障碍组(P<0.05)。结论:本类型精神障碍在现象学层面是一个独立的疾病单元,其生物学特性以及临床特征可能与心境障碍存在更大关联,有待大样本前瞻性研究。建议在精神疾病分类方案与诊断标准中有其正式的归属。     

适应障碍与社会支持的关系研究

目的：探讨社会支持系统与适应障碍发病的关系。方法：采用生活事件量表和社会支持评定量表作为评定工具,对30例适应障碍患者及32名同期遭遇相同应激生活事件的正常人进行对照研究。结果：在同期遭遇相同应激生活事件的情况下,适应障碍组患者的社会支持量表分显著低于对照组。结论：社会支持不足与适应障碍的发病密切相关。     

躯体形式障碍患者生活事件的研究

目的：探讨生活事件、防御机制和社会支持在躯体形式障碍发病中的作用。方法：对60例躯体形式障碍（患者组）与60名健康者（对照组）采用自制的一般情况调查表、汉密尔顿抑郁量表（HAMD,17项）、生活事件量表（LES）、防御方式问卷（DSQ）及社会支持评定量表进行对照研究。结果：患者组生活事件的频度及严重度、不成熟防御机制评分显著高于对照组,而社会支持利用度对照组显著高于患者组。结论：躯体形式障碍患者病前经历了更多、更严重的生活事件,多采用不成熟的防御机制,社会支持的利用度不够。     

社区精神分裂症患者攻击行为的相关因素研究

目的探讨社区精神分裂症患者攻击行为的相关因素,为社区预防精神分裂症的攻击行为提供参考。方法对象为成都市金牛区各社区的精神分裂症患者,年龄18～60岁。其中男性178例,女性122例。分别采用外显攻击行为量表、PANSS、生活事件量表、社会支持量表、MMPI及自编调查表对有攻击行为的患者进行评定、调查,内容包括时间、地点、攻击的对象、方式、原因以及攻击行为造成的危害等;统计方法采用方差分析、直线相关分析及多元回归分析。结果社区精神分裂症患者攻击行为与既往攻击行为史、精神病理分、生活事件量表分、社会支持量表分、MMPI的偏执等因子分相关,与性别、年龄等社会人口学指标无关。结论社区精神分裂症患者攻击行为的发生是偏执冲动人格、心理社会因素、精神症状交互作用的结果。预防或减少社区精神分裂症患者的攻击行为需患者家庭、社区、精神卫生工作者以及全社会的共同努力。     

网络干预对社区精神分裂症患者生活质量的影响及机制

目的 探讨网络干预对社区精神分裂症患者生活质量的影响及其机制.方法 随机抽取的社区精神分裂症患者103例分为网络干预组56例和对照组47例.对干预组进行3个月的网络干预,比较两组患者社会支持、临床症状、药物治疗副作用及生活质量,分析影响患者生活质量的因素.结果 网络干预组主观支持、客观支持、支持的利用度、健康状况问卷(SF-36)分高于对照组,P量表、G量表、副作用量表分低于时照组,均有统计学意义(P＜0.05),患者的客观支持、支持的利用度、G量表分、副作用量表分与患者的生活质量相关.结论 网络干预可以提高患者社会支持和生活质量,减轻临床症状和副作用,客观支持、支持的利用度、G量表分、副作用量表分是网络干预影响患者生活质量的重要因素.     

情感性障碍与生活事件和社会支持的关系

目的 了解生活事件和社会支持与情感性障碍的关系。方法 采用生活事件量表和社会一表作评定工具，地３２例情感性障碍与９６例正常人进行研究。结果 情感性障碍患者负性称独立性生活事件的频度及ＬＥＵ总值均显著高于对照组，而情感性障碍社会支持量表分明显低于对照组，结论 生活事件和社会支持不足与情感性障碍的发病密切相关。     

Associated factors of quality of life in first-episode schizophrenia patients

Objective

Improving quality of life is an important goal in the treatment of schizophrenia. In previous research, quality of life has been reported to be compromised in patients with schizophrenia. The aim of this study was to investigate whether quality of life may be impaired in first-episode schizophrenia patients and to identify the associated factors of quality of life in first-episode schizophrenia.

Methods

Forty-eight patients with first-episode schizophrenia and 20 normal controls were recruited. Quality of life was measured by using the Quality of Life scale (QLS). General and social self-efficacy, perceived social support were measured by using the self-report scales. The clinical assessments and comprehensive neurocognitive battery were also administered.

Results

First-episode group showed significantly decreased QLS total and QLS subscale scores compared to normal controls group. The key associated factors of quality of life in patients with first-episode schizophrenia were the negative symptoms and social self-efficacy.

Conclusion

This finding implies that compromised quality of life may be already emerged in schizophrenia in their first-episode and the psychosocial interventions should be targeting the negative symptoms and the psychosocial protective factors including self-efficacy in addition to simply ameliorating the positive symptoms to foster social reintegration and recovery of first-episode patients.     

Differences in quality of life domains and psychopathologic and psychosocial factors in psychiatric patients

BACKGROUND: Although treatment of severe mental disorders should strive to optimize quality of life (QOL) for the individual patient, little is known about variations in QOL domains and related psychopathologic and psychosocial factors in patients suffering from schizophrenia, schizoaffective disorder, and/or mood disorders. We hypothesized that QOL in severe mental disorder patients would have a more substantial relationship with psychosocial factors than with illness-associated factors. METHOD: A case-control, cross-sectional design was used to examine QOL of 210 inpatients who met DSM-IV criteria for a severe mental disorder and who were consecutively admitted to closed, open, and rehabilitation wards. Following psychiatric examination, 210 inpatients were assessed using standardized self-report measures of QOL, insight, medication side effects, psychological distress, self-esteem, self-efficacy, coping, expressed emotion, and social support. QOL ratings for patients and a matched control group (175 nonpatients) were compared. Regression and factor analyses were used to compare multidimensional variables between patients with schizophrenia and schizoaffective and mood disorders. RESULTS: In all QOL domains, patients were less satisfied than nonpatient controls. Patients with schizophrenia reported less satisfaction with social relationships and medication when compared with patients with schizoaffective and/or mood disorders. Regression analysis established differential clusters of predictors for each group of patients and for various domains of QOL. On the basis of the results of factor analysis, we propose a distress protection model to enhance life satisfaction for severe mental disorder patients. CONCLUSION: Psychosocial factors rather than psychopathologic symptoms affect subjective QOL of hospitalized patients with severe mental disorders. The findings enable better understanding of the combining effects of psychopathology and psychosocial factors on subjective life satisfaction and highlight targets for more effective intervention and rehabilitation.     

青少年强迫症与应激等的关系研究

目的：了解青少年强迫症发病与生活事件、应对方式和社会支持的关系.方法：对44例青少年强迫症患者和214名正常对照者进行一般社会人口学资料表、青少年生活事件量表（ASLEC）、特质应对方式问卷（TCSQ）和领悟社会支持量表（PSSS）的测评.结果：与对照组相比,强迫症组在人际关系、学习压力、受惩罚、健康适应、应激总量的得分上均显著较高（P＜0.05）;强迫症组患者较多采用消极应对方式,较少采取积极应对方式,获得较少社会支持,与正常对照者比较差异非常显著（P＜0.01）.结论：青少年强迫症的发病与负性生活事件、不良应对方式和缺乏社会支持有关.     

冠心病的社会心理因素分析

目的:研究冠心病患者社会心理因素的特点及影响因素。方法:运用生活事件量表(LES)、A型行为量表(TABPSQ)、多伦多述情障碍量表(TAS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)、应付方式问卷(CS)、社会支持问卷(SSS),测定48例冠心病患者(患者组)病前遭遇的生活事件、人格特征、应付方式、社会支持、患病后的心身健康状况及其影响因素,以50名正常健康者为对照。结果:患者组本次患病前经历的生活事件频数及紧张值:TABPSQ评分,消极应付方式评分:抑郁及焦虑分值均显著高于对照组(P均<0.05)。CS的积极应付评分,社会支持总分减低(P<0.05)。家族史、生活事件紧张总值、A型行为和抑郁为冠心病的危险因素,积极应付方式和社会支持为疾病的保护因子。结论:冠心病患者有特殊的心理社会特征和心身健康状况,应采取积极的社会心理干预措施。     

Coping patterns as a valid presentation of the diversity of coping responses in schizophrenia patients

This study aimed to identify coping patterns used by schizophrenia inpatients in comparison with those used by healthy individuals, and to explore their association with selected clinical and psychosocial variables. The Coping Inventory for Stressful Situations (CISS) was used to assess coping strategies among 237 inpatients who met DSM-IV criteria for schizophrenia and 175 healthy individuals. Severity of psychopathology and distress, insight into illness, feelings of self-efficacy and self-esteem (self-construct variables), social support, and quality of life were also examined. Factor analysis, analysis of covariance and correlations were used to examine the relationships between the parameters of interest. Using dimensional measures, we found that emotion-oriented coping style and emotional distress were significantly higher in the schizophrenia group, whereas the task-oriented coping style, self-efficacy, perceived social support and satisfaction with quality of life were lower compared with controls. When eight CISS coping patterns were defined, the results revealed that patients used emotion coping patterns 5.5 times more frequently, and task and task-avoidance coping patterns significantly less often than healthy subjects. Coping patterns have different associations with current levels of dysphoric mood and emotional distress, self-construct variables, and satisfaction with quality of life. Thus, the identified coping patterns may be an additional useful presentation of the diversity of coping strategies used by schizophrenia patients. Coping patterns may be considered an important source of knowledge for patients who struggle with the illness and for mental health professionals who work with schizophrenia patients.     

Adult quality of life and associated factors in adolescent onset schizophrenia and affective psychotic disorders

BACKGROUND: Subjects in treatment for affective disorders are usually less satisfied with life compared to subjects with schizophrenia. AIMS: The aims of this study were to compare subjective quality of life (QoL) at adult age of adolescent onset psychotic disorders and analyse associated factors. METHOD: Fifty-three patients with adolescent onset psychotic disorders were followed up at age 25, diagnostically re-evaluated according to the DSM-IV and assessed with the Positive and Negative Symptoms Scale, the Strauss-Carpenter Scale and the Lancashire Quality of Life Profile. RESULTS: Subjects diagnosed with schizophrenia or schizoaffective disorder (n = 27) experienced significantly lower overall QoL than subjects with psychotic mood disorders (n = 26). Overall QoL was strongly associated to depressed mood (R2 = 0.49) in the schizophrenia group and to degree of employment (R2 = 0.39) in the mood disordered group. CONCLUSION: Depression is a major concern in the evaluation and treatment of patients with schizophrenia, while vocational support seems particularly important after an episode of psychotic mood disorder.     

Familial thyroid disease and delayed language development in first admission patients with schizophrenia

One hundred consecutive first admission patients with a DSM-III-R diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder were compared with 100 randomly selected community controls. Childhood histories of physical, medical, and perinatal trauma, as well as physical and cognitive development, were examined by structured interviews with all available mothers of patients and controls. The prevalence of specific psychiatric disorders and several medical illnesses among first degree and more distant relatives was determined by family history questionnaires. The patient group did not have an excess of childhood head injuries, serious infections, or perinatal/birth complications compared with controls. With social class level taken into account, it was found that the acquisition of reading skills occurred significantly later in patients than controls. Family histories of schizophrenia and thyroid disorders were significantly more frequent among patients than controls. These data fail to indicate any childhood physical or medical environmental trauma that could lead to an increased risk for schizophrenia, although patients were substance abusers to a greater extent than controls. This study also confirms the already known contribution of familial factors and suggests an association of the inheritance of thyroid disorders with schizophrenia. Delayed development of reading skills suggests that precursers of illness may appear early in life before psychosis is evident.     

The role of life events in onset and recurrent episodes of schizophrenia and schizoaffective disorder

The experience of both positive and negative recent life events has long been recognized as a possible precipitant of episodes of psychiatric illness. Among individuals with recurrent mood disorders, investigators have found that recent life events are more likely to be associated with initial and early episodes of illness, with later episodes less likely to be temporally associated with life events. This study investigated the relationship between recent life events and episodes of illness in schizophrenia (defined as the number of acute episodes of schizophrenia requiring hospitalization). Among 32 male U.S. Military veteran inpatients, those with three or fewer episodes of illness reported significantly more recent life events than those patients with more than three episodes of illness (P = 0.01). Overall, recent life events were negatively correlated with number of episodes (P < 0.05). These data suggest that initial or early episodes of schizophrenic illness are more likely to be associated with recent life events than are later episodes.