【作者】 李丽华；

【导师】 王小平；

【作者基本信息】 中南大学 ， 精神病与精神卫生学， 2008， 硕士

【摘要】 目的:调查精神科门诊重性精神病患者及其家属的病耻感状况,探讨门诊重性精神疾病患者及其家属病耻感的相关因素。方法:采用精神疾病病耻感感受问卷、病耻感经历问卷及自编的精神疾病患者及家属一般情况调查表,对2006年10月至2007年4月间到郴州市精神病医院精神科门诊连续就诊,符合CCMD-Ⅲ精神分裂症、心境障碍等重性精神疾病诊断的患者及其家属进行调查,共收集了129例有效的门诊患者及其家属的调查资料,建立数据库,在SPSS11.5 for windows统计软件包上进行统计检验分析。结果:1.病耻感感受问卷显示:70%的门诊重性精神疾病患者及62%的门诊重性精神疾病患者家属同意或强烈认同“因为我(家人)患有精神疾病,所以我觉得生活得不自在”,其均数分别为2.91、2.71。71%的门诊重性精神疾病患者及63%的患者家属同意或强烈认同“我不过多的谈论自己(家人),因为我不想由于我(家人)的精神疾病给别人负担”,其均数分别为2.80、2.68。64%的门诊重性精神疾病患者同意或强烈认同“精神疾病扰乱了我的生活”,均数为2.77。77%的门诊重性精神疾病患者不同意或强烈反对“尽管我患有精神疾病,我仍能拥有美好而充实的生活”,均数为2.98。60%的门诊重性精神疾病患者家属同意或强烈认同“精神疾病使我变成一个艰难的生存者”,其均数为2.69。2.在病耻感经历问卷病耻因子部分的9个条目中,门诊重性精神疾病患者的均数均大于2(最高均数为2.77),家属中有5个条目的均数大于2(最高均数为2.98)。该问卷的歧视因子部分,门诊重性精神疾病患者组中有2个条目的均数大于3(最高均数为3.19),在家属组中有1个条目的均数高达3.87。3.精神分裂症患者和心境障碍患者的病耻感感受问卷中的歧视因子及社会退缩因子分存在差异,除此以外,两组的总分及其他因子分无统计学差异。门诊重性精神疾病患者的病耻感感受问卷总分及其疏离因子、刻板因子、歧视因子和社会退缩因子分高于家属,具有统计学差异。门诊重性精神疾病患者的病耻感经历问卷总分及其歧视因子分高于家属的总分及其因子分,具有统计学差异。4.门诊重性精神疾病患者病耻感感受问卷总分、疏离因子分、社会退缩因子分及病耻感经历问卷总分及歧视因子分与其病期呈负相关;其病耻感感受问卷中的疏离因子分、刻板因子分及病耻感经历问卷总分、歧视因子分与其住院次数呈负相关;不同文化程度的门诊重性精神疾病患者的病耻感感受问卷总分、疏离因子分存在统计学差异;门诊重性精神疾病患者的婚姻状况、自知力及月收入与其病耻感相关。结论:1.门诊重性精神疾病患者和家属均有较高的病耻感感受水平。2.门诊重性精神疾病患者和家属均有过较多的病耻感经历。3.门诊重性精神疾病患者的病耻感总体水平高于家属。精神分裂症患者与心境障碍患者的病耻感水平差别不明显。4.门诊重性精神疾病患者的病耻感水平与其病期及住院次数负相关,门诊重性精神疾病患者的婚姻状况、文化程度、自知力及月收入对病耻感存在影响。更多还原

【Abstract】 Objective:to investigate the experience of stigma and internalized stigma among outpatients with major psychosis and their family members, explore the relevant factors of their stigma.Methods:Internalized Stigma of Mental Illness Inventory,Modified Consumer Experiences of Stigma Questionnaire and Demographic Characteristics were used to assess the outpatients who visited Chenzhou psychiatric hospital from October 2006 to April 2007.The patients meet with the CCMD-Ⅲcriteria of schizophrenia or mood disorder.129 outpatients and their family members were included in this study. SPSS11.5 software was used for statistical analysis.Results:1.70%patients agreed or strongly agreed "I feel out of place in the world because I have a mental illness"(mean:2.91).71% patients agreed or strongly agreed "I don’t talk about myself much because I don’t want to burden others with my mental illness"(mean: 2.80).77%patients disagreed or strongly disagreed "I can have a good, fulfilling life,despite my mental illness"(mean:2.98).62%family members agreed or strongly agreed "I feel out of place in the world because my family have a mental illness"(mean:2.77).63%family members agreed or strongly agreed "I don’t talk about my family members much because I don’t want to burden others with my family members’ mental illness"(mean:2.68),60%family members agreed or strongly agreed "Living with mental illness has made me a tough survivor"(mean:2.69).2.Among 9 items in stigma subscale of Consumer Experiences of Stigma Questionnaire,the mean was higher than 2 in patients group(the highest mean was 2.77).There were 5 items’ mean higher than 2 in family group(the highest mean was 2.98).Among the discrimination subscale of this questionnaire,there were 2 items’ mean higher than 3 in patients group(the highest mean was 3.19),while in family group,only one item’s mean reach to 3.87.3.There were significant differences in discrimination factor and social withdraw factor of Internalized Stigma of Mental Illness Inventory between schizophrenic patients and mood disorder patients in the current study.In addition to,there were no statistical differences in the total scores and other subscale scores of Internalized Stigma of Mental Illness Inventory and Modified Consumer Experiences of Stigma Questionnaire between the two groups.There were different in the total score,alienation factor,stereotype endorsement factor,discrimination factor and social withdrawal factor of Internalized Stigma of Mental Illness Inventory between mentally ill patients and their family members.4.The current study indicated that there was negative correlation between the duration of illness and total scores of Internalized Stigma of Mental Illness Inventory in mentally ill patients group.There was negative correlation between the hospitalizations and total scores of Modified Consumer Experiences of Stigma Questionnaire.There was different in total scores of Internalized Stigma of Mental Illness Inventory between different levels of education in patients.The marital status of the patients and insight and income might have some impacts on the patients’ stigma feeling.Conclusions:1.The mentally ill patients and their family members all have high level of stigma.2.The mentally ill patients and their family members have high frequency of stigma experiences.3.The mentally ill patients have higher level of stigma than their family members.There is no statistical difference in stigma between schizophrenic patients and patients with mood disorder.4.The stigma of mentally ill patients may negative correlate to the duration of disease and the hospitalizations.The marital status and educational level and insight and income have some contribution to the stigma of mentally ill patients.更多还原