【作者】 朱春燕； 孙继军； 江长旺； 张智雯； 汤剑平；

【Author】 Zhu Chunyan;Sun jijun;Jiang Changwang;Zhang Zhiwen;Tang Jianping;

【机构】 杭州市第七人民医院；

【摘要】 目的:探讨首发康复期精神分裂症患者心理防御机制、社会支持、家庭功能的特征。方法:采用心理防御机制、社会支持、家庭功能问卷对138例经新型非典型抗精神病药治疗、康复期精神分裂症患者(患者组)和150例健康人(对照组)的心理防御机制、社会支持、家庭功能进行比较。结果:(1)患者组不成熟防御方式中投射(3.52±1.04)vs(2.43±0.97)、被动攻击(4.40±1.38)vs(3.03±1.05)、抱怨(4.40±1.38)vs(3.03±1.05)、幻想(5.19±1.85)vs(3.42±1.75)、分裂(4.51±0.89)vs(3.64±0.806)、退缩(5.69±1.45)vs(3.72±1.18)、躯体化(5.13±1.26)vs(3.36±1.39),中间型防御方式中反向(4.85±0.98)vs(3.26±0.76)、解除(5.49±1.09)vs(4.26±1.13)、回避(5.18±1.19)vs(4.24±1.02)、利他(4.83±1.39)vs(3.26±1.65)、隔离(4.28±1.06)vs(2.87±1.11)、否认(5.35±1.09)vs(4.39±0.91)、交往倾向(5.46±1.29)vs(4.05±1.49)、期望(6.80±1.51)vs(5.09±1.88)得分高于正常对照组,差异具有统计学意义(P<0.05或P<0.01)。患者组成熟防御方式中压抑(4.99±1.61)vs(6.50±1.75)、幽默(3.80±1.17)vs(5.10±1.12)得分均低于正常对照组,差异有统计学意义(P<0.01)。(2)患者组得到的主观支持(18.12±2.64)vs(22.81±4.45)、客观社会支持(10.273±2.24)vs(12.61±3.27)、支持总分(35.19±5.27)vs(42.34±8.38)以及支持利用度(7.28±2.32)vs(9.26±2.18)低于正常对照组,差异具有统计学意义;(3)患者组的家庭总体功能(2.23±0.09)vs(1.89±0.10)、问题解决(2.15±0.19)vs(1.64±0.16)、沟通(2.17±0.15)vs(1.71±0.14)、角色(2.18±0.13)vs(1.72±0.13)、情感反应(2.29±0.12)vs(1.76±0.16)、情感介入(2.30±0.16)vs(1.86±0.21)、行为控制(2.36±0.14)vs(1.87±0.16)得分均高于对照组,差异具有统计学意义(P<0.01)。结论:首发康复期精神分裂症患者的防御方式存在不成熟倾向,社会支持系统差且家庭功能有缺陷。更多还原

【Abstract】 Objective:To explore the characteristics of the psychological defense mechanisms,social support,and family functioning for first-episode schizophrenia patients in rehabilitation.Methods:138 schizophrenia patients after atypical antipsychotic treatmen in rehabilitation(schizophrenia group),and 150 healthy people(control group) were assessed with defense style questionnaire(DSQ),social support rating scales(SSRS) and family assessment device(FAD).Results:(1)Compared with control group in the immature mechanism,the score of projection(3.52 ±1.04) vs(2.43±0.97),passive aggressive(4.40± 1.38)vs(3.03± 1.05),compla ining(4.40 ± 1.38)vs(3.03 ± 1.05),sutisticfantasy(5.19 ± 1.85)vs(3.42 ± 1.75),schizold(4.51 ± 0.89)vs(3.64 ± 0.806),withdrawal(5.69 ± 1.45)vs(3.72 ± 1.18),,somatization 5.13 ± 1.26)vs(3.36 ± 1.39),and in the middle defense mechanism the score of reaction formation(4.85 ± 0.98) vs(3.26 ± 0.76),removal(5.49 ±1.09) vs(4.26±1.13),avoidance(5.18 ±1.19) vs(4.24± 1.02),pseudo-altruism(4.83 ±1.39)vs(3.26± 1.65),isolation(4.28 ±1.06) vs(2.87± 1.11),denial(5.35 ±1.09) vs(4.39± 0.91),association tendency(5.46 ± 1.29) vs(4.05 ± 1.49),expectations(6.80 ± 1.51) vs(5.09 ± 1.88) were significantly higher.the difference was statistically significant(P <0.05 or P <0.01).In the mature mechanism,suppression(4.99± 1.61) vs(6.50± 1.75) and humor(3.80 ±1.17) vs(5.10± 1.12) were lower than control group.(2)Compared with control group,the objective(18.12±2.64) vs(22.81 ±4.45),subjective support score(10.273 ± 2.24)vs(12.61 ± 3.27),total score(35.19 ± 5.27)vs(42.34 ± 8.38)and the utilization of support(7.28 ± 2.32) vs(9.26 ± 2.18) were markedly lower.(3)The total function(2.23 ± 0.09) vs(1.89 ± 0.10),problem solving(2.15 ± 0.19)vs(1.64 ± 0.16),commucation(2.17 ± 0.15)vs(1.71 ±0.14),role(2.18±0.13)vs(1.72±0.13),affectional reaction(2.29±0.12)vs(1.76±0.16) and behavior control score(2.36 ±0.14) vs(1.87 ±0.16) of the FAD in the schizophrenia patients group were all significantly higher than control.Conclusion:The first-episode schizophrenia patients in rehabilitation showed immature tendency of psychological defense mechanism,and they perceived poorer social support and defected family functioning.更多还原