精神分裂症患者功能失调态度和自动思维及其与精神症状的相关性

目的探讨精神分裂症患者的功能失调态度和自动思维水平及其与精神症状的关系。方法采用功能失调态度问卷(DAS)、自动思维问卷(ATQ)、阳性与阴性症状量表(PANSS)和卡尔加里精神分裂症抑郁量表(CDSS)对66例精神分裂症患者进行评估,同时采用DAS和ATQ对65名正常对照者作评估。结果患者组ATQ分和DAS总分及其脆弱性、吸引和排斥、完美化、强制性和认知哲学因子分均显著高于正常对照组(P<0.05～0.001)。Spearman相关分析显示,患者组ATQ分与DAS总分(r=0.424,P<0.01)及脆弱性(r=0.398,P<0.01)、吸引和排斥(r=0.246,P<0.05)、完美化(r=0.492,P<0.01)、强制性(r=0.247,P<0.05)、寻求赞许(r=0.307,P<0.01)和自主性态度(r=0.340,P<0.01)因子分呈正相关;ATQ分与CDSS分呈正相关(r=0.369,P<0.01);DAS总分与PANSS总分(r=0.267,P<0.05)、阴性症状分(r=0.251,P<0.01)及CDSS分(r=0.465,P<0.01)呈正相关,控制CDSS分后,DAS认知哲学因子分与PANSS阴性症状分的相关性仍具显著意义(r=0.250,P>0.05)。结论精神分裂症患者存在较高的负性自动思维和功能失调态度,刻板的认知方式与阴性症状存在相关,提示认知心理治疗的重要性。

The Relationship among Dysfunctional Attitude,Automatic Thought and Psychiatric Symptoms in Patients with Schizophrenia

Objective To explore the dysfunctional attitude and the automatic thought in patients with schizophrenia,and their relationship with psychiatric symptoms.Methods A total of 66 patients with schizophrenia were assessed with dysfunctional attitude sales（DAS）,Automatic thought questionnaire（ATQ）,the Positive and Negative Syndrome Scale（PANSS）and Calgary Depression Scale for Schizophrenia（CDSS）.65 normal subjects were assessed with DAS and ATQ.Results Compared with the normal controls,schizophrenia patients showed significantly higher ATQ score,DAS total score and its subscores of vulnerability,absorption/exclusive,perfectionism,compulsion and cognitive philosophy（P0.05 or 0.01）.Correlation analysis showed that ATQ score was significantly positively correlated with the total score and subscores of DAS and score of CDSS（P0.05 or 0.01）.DAS total score had a significantly positive correlation with the total score and negative symptom subscore of PANSS and the score of CDSS（P0.05 or 0.01）.The correlation between cognitive philosophy subscore of DAS and negative symptom sbuscore of PANSS remained significant（P0.05）after controlling the depressive symptom.Conclusion Patients with schizophrenia have more automatic thought and dysfunctional attitude which are related to negative symptoms,suggesting the importance of cognitive psychotherapy for patients with schizophrenia.