住院男性慢性精神分裂症患者孤独感调查

目的 探讨住院男性慢性精神分裂症患者产生孤独感的相关因素,为住院慢性精神分裂症患者孤独感的预防提供参考.方法 对106例住院慢性男性精神分裂症患者进行UCLA、ESLI问卷调查.对产生孤独感的相关因素进行积差相关分析,方差分析,筛选产生孤独感的危险因素.结果 患者UCLA、ESLI得分较高,病程长、阴性症状重、疾病分型单纯型、自我效能差是孤独的主要相关危险因素.结论 住院慢性男性精神分裂症患者孤独感严重,应采取积极有效的防治措施,改善阴性症状,提高自我效能,以改善孤独感.     

长期住院精神分裂症患者述情障碍的研究

目的　探讨长期住院的精神分裂症患者的述情障碍问题。方法　对100例长期住院的精神分裂症患者采用多伦多述情障碍量表(TAS量表)评定,并根据年龄、文化程度、病程、住院时间、药物剂量的不同对患者进行分组对比。结果　长期住院的精神分裂症患者 TAS 均分及各因子分高于常模,且不同年龄、病程、住院时间的患者总均分及部分因子分存在明显的差异。结论　长期住院的精神分裂症患者存在一定的述情障碍。     

精神分裂症的共情缺陷及其影响因素

目的探讨精神分裂症患者共情缺陷特点及其影响因素。方法采用人际反应指针量表(IRI-C)对208例精神分裂症患者和213名正常对照的共情能力进行评估,同时作艾森克人格问卷(EPQ)、罗森伯格自尊量表(SES)、一般自我效能感量表(GSES)、简易应对方式问卷(SCSQ)、社会支持量表(SSRS)、多伦多述情障碍量表(TAS-20)和阳性与阴性症状量表(PANSS)等评估,分析影响患者共情能力的相关因素。结果与对照组相比,患者组IRI-C总分、观点采择、幻想力和同情关心因子分均明显减低(P0.01)。患者EPQ的神经质(N)分(r=-0.22)和精神质(P)分(r=-0.18)、TAS因子III分(r=-0.30)、SCSQ积极应对分(r=0.21)、SSRS主观支持分(r=0.16)及GSES分(r=0.21)均与IRI-C总分相关(P0.05)。以IRI-C总分为因变量的回归分析结果显示,SCSQ积极应对分、EPQ的N分和P分、TAS的因子III得分进入回归模型,标准化回归系数分别为0.28、0.30、-0.18、-0.18。结论精神分裂症患者存在广泛的共情缺陷,患者个性特质及其应对方式对共情能力具有影响。     

精神分裂症患者共情能力与社会功能

目的：比较稳定期精神分裂症患者与正常对照者的共情能力,探讨患者共情能力与社会功能的关系。方法：采用人际反应指针量表（IRI-C）对103例稳定期精神分裂症患者（患者组）和88名正常对照者（对照组）进行评估,比较二者的共情能力;同时采用社会功能缺陷筛选量表（SDSS）、个体和社会功能量表（PSP）及阳性与阴性症状量表（PANSS）对患者组进行评估。结果：患者组IRI-C共情性关心分及共情总分平均为（14.7±4.0）分和（44.2±11.3）分,均较对照组的（16.0±4.5）分和（46.3±11.9）分显著为低（P〈0.01或P〈0.05）。控制年龄、症状后的IRI-C与SDSS偏相关分析显示,患者组IRI-C共情性关心分与SDSS中社会性退缩分（r=-0.421,P〈0.01）、责任心和计划性分（r=-0.344,P〈0.05）及总分（r=-0.335,P〈0.05）分别呈负相关。控制症状后的IRI-C与PSP偏相关分析显示,患者组IRI-C观点采摘分（r=0.288,P〈0.01）、共情性关心分（r=0.301,P〈0.01）及IRI-C总分（r=0.268,P〈0.01）与PSP总分均呈正相关。结论：精神分裂症患者存在共情能力障碍,其共情能力与其社会功能存在正相关。     

长期住院的慢性精神分裂症患者社会功能缺陷的相关因素分析

以“住院精神病人社会功能缺陷筛选表”对８５例长期住院的慢性精神分裂症病人进行评定，结果社会功能缺陷的出现率为 ８３．５％。通过相关因素的分析认为：积极治疗患者的精神症状，缩短住院时间，增加假出院次数及时间，积极调动社会和家庭的关系，对减轻病人社会功能缺陷，提高其社会适应能力具有重要意义。     

100例长期住院的慢性精神分裂症病人社会功能缺陷的多因素分析

采用郭氏修定的“住院精神病人社会功能缺陷筛选表”，以多因素分析的方法，对在我院长期住院的１００例慢性精神分裂症病人进行评定分析，结果住院时间、阴性症状、阳性症状、智能、年假出院天数对社会功能缺陷有显著影响。     

SSSI对慢性精神分裂症住院患者社会功能缺陷的评估

应用ＳＳＳＩ对８８例慢性精神分裂症住院患者社会功能缺陷评定结果为，极重度３１例，重度６例，中度１３例，轻度３６例，无２例，残疾率９７％，并对精神残疾等级与有关因素的关系进行了分析，提示了ＳＳＳＩ设计内容合理，具有较好的实用性和可操作性，适于临床康复的评定。     

恢复期精神分裂症病人述情障碍的对比分析

目的　评估恢复期精神分裂症病人的述情障碍 ,并比较其缺陷型和非缺陷型的述情障碍严重程度。方法　采用多伦多述情障碍量表 (Torontoalexithymiascale ,TAS)对 6 6例恢复期精神分裂症病人及 6 2例正常人进行测查。结果　恢复期精神分裂症病人的TAS得分显著高于正常人 (P <0 0 5或P <0 0 1) ,其缺陷型的TAS得分也显著高于非缺陷型 (P均 <0 0 1)。结论　恢复期精神分裂症病人大多存在述情障碍 ,其中缺陷型病人的述情障碍更为严重。严重的述情障碍可能是精神分裂症病情加重或存在原发阴性症状的一个标志。     

精神分裂症的嗅觉缺陷

本文就与精神分裂症患者嗅觉缺陷的相关因素作了介绍。     

长期住院的精神分裂症男女患者对比

调查本次住院时间超过１年的精神分裂症患者临床资料,分析精神分裂症趋向慢性阶段的临床现状,长期住院原因,并对男女资料进行对比。作者单位：５１５０２１　广东汕头市第四人民医院１　对象与方法对我院男女各两个病区于１９９８年６月下旬时的精神分裂症患者进行调查,以符合ＣＣＭＤ－２－Ｒ诊断标准,且住院时间超过１年者作为入组对象。在共计住院２７０例中,入组者７３例（２７．０％）。男性１１０例中入组４５例（４０．９％）,女性１６０例中入组２８例（１７．５％）,入组率以男性显著较高（χ２＝１０．１４,Ｐ＜０．０１…     

Remission and cognitive ability in a cohort of patients with schizophrenia

INTRODUCTION: Patients with schizophrenia were studied regarding their ability of achieving symptomatic remission. It was found that only approximately one-third of the patients fulfilled the criteria for remission. The importance of cognitive performance was studied to decide whether cognitive ability is a contributing factor for achieving remission. MATERIALS AND METHODS: A homogeneous cohort of 211 patients, of whom 76 patients attained remission (36%), and 135 patients (64%) failed to, was studied. Remission was decided by the use of eight items from the PANSS in which none of these items should have a score above three points. The patients were also tested on a comprehensive battery of cognitive tests including vigilance, working memory, long-term memory, executive functioning, learning performance, visuomotor speed/efficacy, cognitive flexibility and pre-morbid functioning. RESULTS: Marked differences were exhibited in the cognitive abilities in all domains of patients who had attained remission in comparison with those who had not. DISCUSSION: This study highlights the importance of cognitive performance as one possible predictor of remission. Patients without remission had lower cognitive ability and may have more difficulty in benefiting from, or complying with their treatment. As a consequence, various forms of supportive treatment might increase the likelihood of remission.     

Physiological evidence of a deficit to enhance the empathic response in schizophrenia

Empathy is crucial for maintaining effective social interactions. Research has identified both an early-emotional sharing and a late-cognitive component of empathy. Although considered a functionally vital social cognition process, empathy has scarcely been studied in schizophrenia (SZ). We used event-related potentials (ERPs) to study the temporal dynamics of empathic response in 19 patients with SZ and 18 matched healthy controls (HC) using an empathy for physical pain paradigm. Participants responded to pictures of hands in neutral and painful situations in an active empathic condition and one manipulated by task demands. Additionally, subjective ratings of the stimuli and empathic self-reports were collected. People with SZ had (1) decreased early-emotional ERP responses to pictures of others in pain; (2) decreased modulation by attention of late-cognitive ERP responses; (3) lower ratings of perspective taking and higher ratings of personal distress which were both related to decreased modulation of late-cognitive empathic responses; (4) a significant relationship between high affective overlap between somebody else's pain and their own pain and decreased modulation of late-cognitive empathic responses; (5) a distinct relationship between regulatory deficits in late-cognitive empathy and functioning. Patients had present but reduced early and late empathy-related ERPs. Patients also reported increased personal distress when faced with distress in others. The late ERP responses are thought to be associated with self-regulation and response modulation. The magnitude of these late responses was inversely associated with reported levels of personal distress in both patients and controls. Additionally, regulatory deficits in cognitive empathy were highly related with deficits in functioning. Decreased ability to regulate one's own emotional engagement and response to emotions of others may be an important source of distress and dysfunction in social situations for patients with schizophrenia.     

Impairments in executive functioning in patients with remitted and non-remitted schizophrenia

Objective

Although deficits in executive functioning are prominent in schizophrenia, some patients in remission have shown significantly higher levels of neurocognitive functioning than patients not in remission. However, no consensus on the relationship between neurocognitive functioning and the severity of symptoms has been reached. Additionally, previous studies have mainly examined the primary symptom domains of schizophrenia without considering the influence of anxiety symptoms, which are likely to influence neuropsychological performance. The aim of the present study was to compare the executive functioning of normal controls and with that of patients with schizophrenia in acute and remitted states. We further examined associations between impaired executive functioning in patients and anxiety levels.

Methods

Using a battery of tests assessing executive functioning including subtests of the Cambridge Neuropsychological Automated Test Battery (CANTAB) and the short form of the Korean Wechsler Adult Intelligence Scale (K-WAIS), we assessed 54 patients with schizophrenia and 33 normal controls.

Results

Our results showed that patients with non-remitted schizophrenia obtained significantly lower estimated IQ scores than did normal controls. They also exhibited longer reaction times on the Choice Reaction Time (CRT) test and the Stop Signal Test (SST) subtests of CANTAB and a greater number of total errors and errors that occurred before the extradimensional stage (i.e., pre-ED errors) on the Intradimensional/Extradimensional Shift (IED) subtest of CANTAB. Furthermore, those with schizophrenia in acute states showed significantly slower stop signal reaction times (SSRT) on the SST than did those with remitted schizophrenia and healthy controls. Finally, differences in the pre-ED errors and total adjusted errors on the IED became insignificant when scores on the Beck Anxiety Inventory (BAI) were entered as the covariate, whereas other significant differences remained when these scores were entered.

Conclusion

Differences in executive functioning exist between patients with schizophrenia and healthy controls; these differences can be largely attributed to the relatively poor performance of patients in an active state.     

Opioid abuse and hospitalization rates in patients with schizophrenia

Background: Substance abuse worsens the course of schizophrenia, but it is not known whether or not there are differences between specific substances concerning their association with the hospitalizations of patients with schizophrenia. Aims: The primary aims of this study were to examine the possible associations between amphetamine, cannabis, and opioid abuse, and the risk of hospitalizations among patients with schizophrenia. Methods: The study population consisted of 146 patients with ICD-defined schizophrenia from two different geographical sites in Finland, and it included both inpatients and outpatients. Data were collected retrospectively from the patients’ medical files. Substance abuse was defined as either harmful use or dependence according to ICD-10. Results: The cumulative prevalence of substance abuse was 10.9% (16/146) for cannabis, 8.9% (13/146) for amphetamine, and 4.1% (6/146) for opioids. Among patients with schizophrenia and abuse of any substance, the number of hospitalizations was about 1.5-fold when compared to those without substance abuse. The incidence rate ratio for hospitalizations was 2.9 (95% CI 2.47–3.63) for opioids, 2.0 (1.71–2.41) for amphetamine, and 1.6 (1.33–1.84) for cannabis, when compared with no abuse of each substance. The risk of hospitalizations was significantly higher for opioids when compared with amphetamine (p < 0.001) or cannabis (p < 0.001). Conclusions: Harmful use or dependence of opioids among patients with schizophrenia is associated with significantly higher risk of hospitalizations than either harmful use or dependence of amphetamine or cannabis.     

利培酮治疗精神分裂症患者出院后3年随访研究

目的 探讨精神分裂症患者出院后利培酮使用状况及有效性、安全性及相关问题。方法 对128例经利培酮治疗出院的精神分裂症患者，每1～2个月门诊随访一次，视病情调整治疗方案，共随访三年。临床疗效总评量表(CGI)评定疗效。结果 共有90例患者完成了3年的随访观察，其中30例患者利培酮治疗3年。对维持治疗效果良好中断治疗的因素有多种。结论 利培酮长期治疗精神分裂症有效、安全。中断治疗易复发或加重，应针对相关原因和问题对精神分裂症患者出院后的维持治疗进行干预。     

Sensitivity to expressions of pain in schizophrenia patients

Patients with schizophrenia tend to neglect their own pain and are known to have impairments in the processing of facial expressions. However, the sensitivity to dynamic expressions of pain has not been studied in these patients. Our goal was to test this ability in schizophrenia and to probe the underlying cognitive processes. We hypothesized that patients would have a reduced sensitivity to expressions of pain and that this impairment would correlate with deficits in attention, working memory, basic emotions recognition and with positive symptoms. We applied a battery of tests composed of the Comprehensive Affect Testing System (CATS), Sensitivity to Expressions of Pain (STEP), Toulouse-Pierón, Stroop and Digit Span tests to two groups of individuals, 27 patients with the diagnosis of schizophrenia and 27 healthy volunteers, matched on age, education and gender. Symptoms were assessed using Brief Psychiatric Rating Scale. The sensitivity to expressions of pain was found to be impaired in schizophrenia and a bias to attribute lower pain intensities may be present at some discrimination levels. STEP performance was correlated with working memory but not with Affect Naming or attention. These findings may contribute to the improvement of cognitive remediation strategies.     

Symptomatic remission and social/vocational functioning in outpatients with schizophrenia: Prevalence and associations in a cross-sectional study

PURPOSE: Progress in therapeutic options for schizophrenia has revived long-term expectations of researchers, practitioners and patients. At present, definitions of therapeutic outcome include both maintained symptomatic remission and appropriate functioning in a conceptual framework that targets patient's recovery as the ultimate goal. We aimed to know the prevalence and clinical features of patients with schizophrenia achieving these outcomes. METHODS: A multi-centre, cross-sectional study was performed in more than 100 mental health facilities within Spain. Recently published consensus-based operational criteria for symptomatic remission and the Global Assessment of Functioning scale were used to evaluate outcomes. Other clinical aspects like depressive symptoms, social cognition, premorbid adjustment and patients' attitudes to medication were also evaluated. RESULTS: Data from 1010 patients were analysed. Of these, 452 (44.8%) were at clinical remission, but only 103 (10.2%) showed an adequate social and/or vocational functioning. Factors predicting both outcomes were better pre-morbid adjustment (odds ratio, OR=1.56) and better social cognitive function (OR=1.14). Other factors, like treatment adherence, current or past psychotherapy and patient's age were not associated to functionality but only to clinical remission. Current substance use and previous rehabilitation were associated to a lower likelihood of symptomatic remission. CONCLUSION: Although symptomatic remission in patients with schizophrenia is a realistic and reachable goal, future efforts should be directed to a sustained appropriate functioning in these patients.     

精神分裂症患者的自知力及其对精神症状认识的研究

目的研究精神分裂症患者对症状的认识及其与自知力、精神病理症状及疾病严重程度的关系.方法由患者和医生分别评定4个阳性症状和4个阴性症状在患者身上的表现程度.同时由医生对患者进行ITAQ、BPRS、SANS、SAPS、CGI评定.结果患者对自身阳性和阴性症状的总评分分别为(16.79±3.67)和(16.02±3.81),明显高于医生评定的(15.46±4.25)和(13.22±4.22),患者对自身症状的评分ITAQ、BPRS、SANS、SAPS、CGI均具有一定程度的相关.结论患者对自身症状的认识明显不足,特别是阴性症状.患者对症状的认识与其自知力、疾病严重程度、精神病理症状有关.