【摘要】 目的:探讨慢性精神分裂症患者自知力与精神症状的关系。方法:选择2001-01/2002-06北京市安康医院慢性精神分裂症患者120例。均为长期使用抗精神病药物,住院时间2个月～35年,年龄28～63岁,男90例,女30例。使用修订后的Markova自知力自评量表由患者自行评定,同时由医生对患者进行简明精神病量表、阴性症状量表、阳性症状量表评定。修订后自知力自评量表共28项问题,7个因子。每项问题分3个选择性答案(即从无到有,从轻到重)。评分标准:0分=无(重)(错),1分=时有时无(中等)(较正确),2分=一直有(轻)(正确)。结果:120例均进入结果分析,无脱落。①自知力自评量表评分与简明精神病量表评分相关分析:慢性精神分裂症患者自知力总分与简明精神病量表总分呈明显负相关,但在各因子中,表现为对自我变化的认识与活动过多和敌意猜疑无相关性,余呈负相关。②自知力自评量表评分与阴性症状量表评分相关分析:慢性精神分裂症患者自知力总分与阴性症状量表总分呈明显负相关,自知力中因子对环境变化的认识与阴性症状量表总分、思维贫乏、注意损害呈负相关,而与阴性症状量表其他3因子无特异性相关。自知力因子对自我变化的认识与阴性症状量表总分无相关,仅与思维贫乏、注意损害呈负相关。自知力因子中对自我处境的认识与阴性症状总分及其他因子均呈负相关。③自知力自评量表评分与阳性症状量表评分相关分析:慢性精神分裂症自知力总分与阳性症状量表总分呈负相关,在各因子中,自知力总分与怪异行为、阳性思维形式障碍呈负相关,与幻觉、妄想、情感不协调无相关性。自知力各因子中对住院治疗的态度与期望、意识到自身的变化、对存在疾病的认识与阳性症状量表总分呈负相关。而幻觉、妄想仅与自知力中对存在疾病的认识相关;情感不协调不影响自知力以及其各因子。结论:阴性症状更多地影响慢性精神分裂症患者的自知力,而阳性症状中的某些项目与自知力中的个别因子相关。更多还原

【Abstract】 AIM: To explore the relation of insight and psychiatric symptom in patients with chronic schizophrenia.METHODS: 120 patients with chronic schizophrenia treated at the Beijing Ankang Hospital from January 2001 to June 2002 were selected. They all used antipsychotic drugs for a long term with 2 months - 35 years length of stay, aged from 28 to 63 years old, 90 males and 30 females. The self-rating scale of insight developed by Markova was used to assess the patients by patients themselves, and at the same time brief psychiatric rating scale (BPRS), scale for assessment of negative symptoms (SANS) and scale for assessment of positive symptoms (SAPS) were used by the doctors to assess the patients.After being modified, the self-rating scale of insight included 28 questions, and 7 factors. Every item included 3 selective answers (i.e. from nothing to some, from mild to severe). Score standard: 0 point=nothing (severe) (wrong), 1 point=sometimes had or did not have (moderate) (nearly correct), 2 points=always had (mild) (correct). RESULTS: 120 cases were all involved in the result analysis without drop. ① Correlation analysis of scores of self-rating scale of insight and BPRS: The total score of insight had significant negative correlation with that of BPRS in patients with chronic schizophrenia, but in each factors, the self-change cognition had no correlation with more activity and hostile-suspiciousness, and others showed negative correlation. ② Correlation of scores of self-rating scale of insight and SANS: The total score of insight had significant negative correlation with that of SANS in patients with chronic schizophrenia.The cognition on environment changes in the insight factors had negative correlation with general score, poverty of thought and attention lesion of SANS, while there was no special correlation with other 3 factors of SANS. The cognition of self-change in the insight factor had no correlation with the total score of SANS, only had negative correlation with poverty of thought and attention lesion. The cognition on self-condition in the insight factors all had negative correlation with the general score and other factors of negative symptom. ③ Correlation analysis of self-rating scale of insight and SAPS: General score of insight of chronic schizophrenia showed negative correlation with general score of SAPS. In each factor, the general score of insight showed negative correlation with abnormal behavior and handicap of positive thinking formation, and had no correlation with hallucination, delusion and incongruity of affect. The attitude and expectation on inpatients care, self-change consciousness, cognition on the existing disease in the insight factors had negative correlation with the total score of SAPS. While the hallucination and delusion only had relation with cognition of the existing disease in the insight; The incongruity of affect had no cognition on effects on insight and other factors. CONCLUSION: The negative symptoms have a more effect on the insight in patients with chronic schizophrenia, while some items of the positive symptoms are related to individual factors in insight.lucination更多还原