青少年精神分裂症患者家庭因素的研究

目的:探讨青少年精神分裂症患者的发病和家庭因素的相关性.方法:采用父母养育方式评价量表(EMBU)及家庭环境量表中文版(FES-CV)对60名青少年精神分裂症患者进行测评并与60名健康青少年进行对照及相关分析.结果:青少年精神分裂症患者父母养育方式与正常组对照显示:其父亲惩罚严厉、拒绝否认因子分显著高于对照组,情感温暖、理解因子分显著低于对照组(P＜0.05或P＜0.01);其母亲过分干涉过度保护、偏爱被试因子分显著高于对照组;母亲的情感温暖理解、过度保护、偏爱被试因子分高于父亲(P＜0.05或P＜0.01).家庭环境的亲密度、情感表达、文化性、娱乐性的因子分低于对照组,矛盾性和控制性均高于对照组(P＜0.05或P＜0.01).相关分析显示:父亲过度保护与母亲拒绝否认,及母亲过度保护与父亲拒绝否认因子之间呈负相关(r≥0.8);父亲与母亲EMBU相同因子得分具有相关关系(r≥0.6).结论:不良的家庭环境和父母养育方式对青少年精神分裂症的发病起一定作用,具有相关性.     

住院精神分裂症患者攻击行为的相关因素研究

目的 分析住院精神分裂症患者攻击行为的特征及相关因素,以利防范。方法 采用自制调查表和父母养育方式评价量表（EMBU）调查住院精神分裂症患者235例,以有攻击行为的52例为研究组,无攻击行为的183例为对照组。结果 两组在年龄、文化程度、既往攻击行为史、自知力、幻觉妄想、脑电图和地形图方面有显著性差异。有攻击行为的精神分裂症患者,父母养育方式中的惩罚严厉、过分干涉、过度保护、拒绝否认因子分显著高于对照组。结论 住院精神分裂症患者发生攻击行为的相关因素是多方面的,应了解精神分裂症患者发生攻击行为的各种可能因素,对重点病人采取及时有效的药物治疗和心理疏导,并加强精神科监护,以减少精神分裂症患者攻击行为的发生。     

养育方式对青少年心理门诊患者应对方式的影响

目的:了解青少年心理门诊患者的应对方式与父母养育方式的关系. 方法:对107例青少年心理门诊患者(研究组)和104名正常青少年(对照组)进行应对方式和父母养育方式的测评,比较两组之间的差异,并对应对方式和父母养育方式作相关分析. 结果:研究组解决问题、求助的应对方式的评分显著低于对照组,而自责、退避、幻想的方式的评分显著高于对照组;研究组父母养育方式中,父母情感温暖因子评分显著低于对照组,而父母惩罚严厉、拒绝否认因子评分显著高于对照组(P<0.05或P<0.01).相关分析中,积极的应对方式与父母正性的情感因子呈正相关(P<0.05或P<0.01),而消极的应对方式则与父母负性的情感因子呈正相关(P<0.05或P<0.01). 结论:青少年心理门诊患者多采用消极的应对方式,且明显受到父母养育方式的影响.     

青少年心理障碍与家庭功能相关性研究进展

青少年是人的心理发育的一个重要时期,因生理因素、社会环境、养育方式以及心理创伤等多方面产生的不良影响,导致了这一时期产生的特有心理变化和心理行为问题.在中国特色的家庭模式下,父母的教养方式、家庭环境等发挥着重要作用,本文对此研究进展进行了综述.     

精神分裂症患者特质焦虑与自我接纳和父母养育方式的相关研究

目的：探讨精神分裂症患者特质焦虑与自我接纳和父母养育方式的相关性。方法：对36例25岁以下精神分裂症的特质焦虑与自我接纳和父母养育方式进行调查评定及相关分析。结果：特质焦虑得分明显高于正常人群，父母养育方式中情感温暖、理解和偏爱、过度保护得分低于正常参考指标。相关分析显示：特质焦虑与母亲Ⅲ、Ⅳ因子呈正相关，与自我接纳因子呈负相关，与年龄无相关性。结论：拒绝、否认、惩罚、严厉等损害自尊，降低自我接纳程度的方式与特质焦虑的产生有关；特质焦虑不会随年龄增加发生改变。     

青少年精神分裂症患者住院时间的影响因素

目的 探讨青少年精神分裂症患者住院时间的影响因素。方法 以收治本院的50例青少年精神分裂症患者（收集时间：2019年10月～2021年10月）为研究样本,回顾性调查患者人口学资料、临床资料、家属相关资料等,分析影响患者住院时间的相关因素。结果 留守、由家属陪护、家属对精神疾病态度不良、无医保、治疗无效、出现不良反应的患者其住院时间与非留守、无家属陪护、家属态度良好、治疗有效、无不良反应患者的住院时间存在统计学差异（P<0.05）;Logistic分析显示：留守、家属陪护、家属对精神疾病态度、医保、治疗效果、不良反应是影响患者住院时间的危险因素（P<0.05）。结论 影响青少年精神分裂症患者住院时间的主要因素为家属陪护、留守儿童、家属对精神障碍疾病态度不良、治疗无效、出现不良反应,进而对患者住院治疗及早期康复造成不良影响,临床需大力普及精神卫生知识,提供有效心理疏导,以减少不良影响因素。     

父母教养方式对精神分裂症患者个性的影响

精神分裂症是发病率较高的精神疾病之一，有人提出了精神分裂症患者存在特殊的个性特征［１］。作者用父母教养方式评价量表与艾森克个性问卷对我院住院精神分裂症患者进行了测查，现将结果报告如下。１材料与方法１．１调查对象（１）研究组：为我院１９９６年１１月至１...     

精神分裂症患者家庭关系和父母教养方式的对照研究

目的 研究精神分裂症患者家庭人际关系和父母教养方式的特点。方法 采用家庭环境量表中文版和父母养育方式评价量表,对处于缓解期的100例精神分裂症患者（研究组）与按1：1配对原则挑选的100名正常人（对照组）进行测试。结果 （1）与对照组比较,研究组的家庭关系表现为低亲密度、低情感表达、低成功性及低组织性,以及高矛盾性及控制性差（P＜0．05或P＜0．01）。（2）在教养方式上,患者的父亲表现为低情感温暖、高惩罚严厉、过分干涉和拒绝否认（P＜0．01或P＜0．05）;患者的母亲表现为低情感温暖、高拒绝否认和惩罚严厉（P＜0．01）。（3）Logistic回归分析,研究组的家庭环境及父母教养方式的风险因素为家庭成员的控制性差,以及父亲的过分干涉、拒绝及否认（P＜0．01－P＜0．05）。结论 精神分裂症患者的家庭人际关系和父母养育方式存在多方面问题,可能对精神分裂症的发病起重要作用。     

首发儿童青少年精神分裂症患者父母的心理状态

目的:探究首发儿童青少年精神分裂症患者父母的心理状态。方法:招募首发儿童青少年精神分裂症患者的父母98名(研究组)与健康对照者98名(对照组)。对患儿父母采用Link病耻感系列量表评估病耻感;采用Herth希望量表(HHI)、心理弹性量表(CD-RISC)和社会支持评定量表(SSRS)评估其希望水平、心理弹性和社会支持。将病耻感各维度得分与中点分比较,并比较两组间的HHI、CD-RISC和SSRS评分。结果:患儿父母的贬低-歧视感知量表(PDD)总分、病耻感应对量表(CO)总分及各因子评分、病耻感情感体验量表(SRF)总分和误解因子评分显著高于中点分(P均0.05)。研究组HHI、CD-RISC及SSRS总分及各因子分均显著低于对照组(P均0.001)。结论:首发儿童青少年精神分裂症患者父母的病耻感较高,希望水平、心理弹性水平及社会支持水平都较低。     

精神分裂症的攻击性行为与父母养育方式的相关性分析

本文试图探讨父母养育方式对精神分裂症攻击性行为的影响。现报道于后。1 对象与方法 1.1 对象 研究对象为1999年2月～2000年11月于本院住院的精神分裂症患者。入组标准:①符合CCMD-2-R中精神分裂症的诊断标准。②排     

住院精神分裂症患者家庭负担的影响因素研究

目的:探讨精神分裂症患者家庭负担的影响因素。方法:应用家庭负担访谈问卷(FEIS)、阳性和阴性症状量表(PANSS)及自知力和治疗态度问卷(ITAQ)对334例精神分裂症患者及其照料者进行评估。结果:回归分析显示患者的性别、婚姻状况、病情程度及自知力完善程度,以及照料者就业状况、是否与患者同住及与患者接触频率均为家庭负担的影响因素。结论:影响精神分裂症患者家庭负担的因素复杂多样,精神科卫生从业人员应有针对性地对患者及其家庭成员进行心理干预以减轻家庭负担。     

Do perceived parental rearing patterns influence social behaviour dimensions and disease severity in schizophrenia?

In an explorative study, a clinical sample of 53 schizophrenic patients was examined. The EMBU inventory was used for measuring perceived parental rearing practices, the AfS for rating the quality of relationship to key relatives and the U-Scale for assessing social anxiety. The findings obtained were intercorrelated and compared with 3 selected parameters of disease severity: age at first hospitalization, number of treated episodes and length of hospital stay. The results suggest that the quality of contact with key relatives is determined to a larger extent by the schizophrenia than by parental rearing attitudes. Rearing behaviour more likely influences the age at first hospitalization and social anxiety, whereas considering the length of face-to-face contact, the quality of the relationships between patients and their key relatives can be assumed to be associated with the duration of hospital stays.     

Does family history of schizophrenia influence age at onset of schizophrenia?

The relation between age at onset of schizophrenia diagnosed using DSM-III criteria and the presence or absence of this illness among first-degree relatives was investigated in 2417 patients. The mean age at onset among those with a family history of schizophrenia was slightly and nonsignificantly earlier than that of schizophrenic patients without a positive family history. The former developed their illness before the age of 25 years more frequently than did the latter.     

The relationship between coping style and burden in the carers of reatives with schizophrenia

The development of a questionnaire to measure the coping style of people caring for a relative with schizophrenia is described. Data on the psychometric properties of this questionnaire are reported for a sample of 91 carers. It is shown that coping style is associated with carer burden and psychological distress. In particular, the coping styles ‘collusion’, ‘criticism/coercion’,‘overprotectiveness',‘emotional over-involvement’ and‘resignation’ were found to be associated with higher levels of carer burden, and the coping style‘warmth’ was found to be associated with lower levels of carer burden.     

Influence of gender on social outcome in schizophrenia

OBJECTIVE: To study the relevance of gender on social functioning in schizophrenia. METHOD: A sample of 200 schizophrenic (DSM-IV criteria) out-patients were followed-up during 2 years and were administered the following instruments: Positive and Negative Symptom Scale (PANSS), Disability Assessment Scale (DAS-sv), and Global Assessment of Functioning (GAF) Scale. A regression model was created with DAS and GAF as dependent variables, and gender, PANSS, age of onset, duration of illness and marital status as independent variables. Separate regression models were then generated for females and males. RESULTS: Gender influenced significantly on DAS and GAF, with men showing worse functioning. In gender specific analyses, we found a significant influence of illness duration and Positive and Negative PANSS on social functioning in men, and of age at onset and Negative PANSS in women. CONCLUSION: Gender had a significant influence on social functioning in schizophrenia, even after adjusting for the other independent variables.     

精神分裂症患者应对方式、父母教养方式及防御方式的性别差异

目的:探讨精神分裂症患者应对方式、父母教养方式及防御方式的性别差异。方法:采用应付方式问卷(CSQ)、父母教养方式问卷(EBMU)及防御方式问卷(DSQ)对96例男性与75例女性精神分裂症患者进行评估。结果:应付方式:男性患者使用幻想少于女性(F=2.77,P0.05),使用自责、退避多于女性(F=3.76,F=2.76;P均0.05)。父母教养方式:父亲对儿子采取拒绝否认大于女儿(F=4.82,P0.01);母亲对儿子采取拒绝否认小于女儿(F=2.87,P0.05)。防御方式:男性患者采用退缩、反作用形成、消耗倾向多于女性,采用幻想、躯体化、期望少于女性(P均0.05)。结论:不同性别精神分裂症患者的应对方式、父母教养方式及防御方式不同,心理干预应有性别针对性。     

Medical cost analysis of family psychoeducation for schizophrenia

Family psychoeducation has been shown to prevent the relapse of schizophrenia. However, whether medical costs are reduced by this approach remains uncertain. The subjects were patients with schizophrenia who lived with high-expressed emotion (EE) families and were at high risk of relapse. A total of 30 patients whose families underwent psychoeducation and intensive family sessions or psychoeducation and subsequent support were regarded as the psychoeducation group. A high-EE group without family psychoeducation made up of 24 patients was used as a control group. The mean outpatient medical cost, duration of hospitalization, inpatient medical cost, and total medical cost during the follow-up period were compared between the psychoeducation group and the control group. The mean inpatient medical cost was 270,000 yen in the psychoeducation group and 470,000 yen in the control group. The mean total medical costs were 500,000 yen in the psychoeducation group and 710,000 yen in the control group. The cost in the psychoeducation group was significantly lower than the control group by Mann-Whitney U-test. The proportion of patients with a total medical cost greater than the median value was 23% in the psychoeducation group and 54% in the control group with a significant difference. The medical cost can be reduced in the psychoeducation group compared with the control group due to the prevention of re-hospitalization by family psychoeducation.     

Clinical factors related to schizophrenia relapse

Objective: Relapses represent one of the main problems of schizophrenia management. This article reviews the clinical factors associated with schizophrenia relapse. Methods: A research of the last 22 years of literature data was performed. Two-hundred nineteen studies have been included. Results: Three main groups of factors are related to relapse: factors associated with pharmacological treatment, add-on psychotherapeutic treatments and general risk factors. Overall, the absence of a maintenance therapy and treatment with first generation antipsychotics has been associated with higher risk of relapse. Further, psychotherapy add-on, particularly with cognitive behaviour therapy and psycho-education for both patients and relatives, has shown a good efficacy for reducing the relapse rate. Among general risk factors, some could be modified, such as the duration of untreated psychosis or the substance misuse, while others could not be modified as male gender or low pre-morbid level of functioning. Conclusion: Several classes of risk factors have been proved to be relevant in the risk of relapse. Thus, a careful assessment of the risk factors here identified should be performed in daily clinical practice in order to individualise the relapse risk for each patient and to provide a targeted treatment in high-risk subjects.     

Hypofrontality in schizophrenia: Influence of normalization methods

1. 1. Studies with Single Photon Emission Computed Tomography (SPECT) in schizophrenia research have utilized different approaches to normalization of data, such as cerebellar ratio and whole brain ratio methods, leading to conflicting findings.

2. 2. The authors compared these two methods to test the hypofrontality hypothesis of schizophrenia.

3. 3. Eighteen chronic and medicated DSM-IV schizophrenic patients and 10 healthy controls underwent two SPECT examinations using ^99mTc-HMPAO as a tracer at baseline and during frontal activation while applying the Wisconsin Card Sorting Test.

4. 4. The hypofrontality hypothesis was supported with both indexes of relative perfusion, although the whole brain ratio method appeared to be more reliable and specific than the cerebellar ratio method.

5. 5. Further studies are required to confirm these preliminary results on the specificity and sensitivity of both methods.