不同精神残疾程度的精神分裂症患者精神症状比较分析

摘要

Objective To compare psychiatric symptoms of schizophrenia patients at different levels of mental disability and to investigate the relationship between the level of mental disability and psychiatric symptoms in patients with schizophrenia. Methods We enrolled 119 schizophrenia outpatients from Hengshui Mental Hospital in January to April 2012. The scale of WHO-DASⅡ was administered to assess the level of mental disability and the Positive and Negative Syndrome Scale ( PANSS ) was used to assess the severity of psychiatric symptoms. Psychiatric symptoms scores were compared among schizophrenia patents with different levels of mental disability. Results The total scores of PANSS were ( 82. 28 ± 8. 87 ), (78. 54 ±9. 24)and(76. 32 ±9. 08)for severe,moderate,and mild mental disability,with the differences significant(F=7. 148,P=0. 000). Significant difference existed among three levels in the total scores of positive syndrome scale and negative syndrome scale(P﹤0. 05). Patients at different levels of mental disability were significantly different in score of delusions, grandiosity,suspiciousness/persecution,hostility in positive syndrome scale,difficulty in abstract thinking in negative syndrome scale,and anxiety, guilt feelings and poor impulse control in general psychopathology scale ( P ﹤0. 05 ) . Conclusion Schizophrenia patients at different levels of mental disability have different scores in psychiatric symptoms. Positive and negative symptoms of patients with schizophrenia are associated with the mental disability level, especially delusions, grandiosity, suspiciousness/persecution,hostility,difficulty in abstract thinking,anxiety,guilt feelings and poor impulse control.%目的：比较不同精神残疾程度的精神分裂症患者的精神症状，探讨精神分裂症患者精神残疾水平与精神症状的关系。方法选取2012年1—4月在衡水市精神病医院门诊就诊的精神分裂症患者119例为研究对象。采用世界卫生组织残疾评定量表（ WHO-DASⅡ）评估患者的精神残疾水平，采用阳性与阴性症状量表（ PANSS）评估患者精神症状的严重程度，比较不同精神残疾程度的精神分裂症患者精神症状评分情况。结果重、中、轻度残疾精神分裂症患者PANSS总分分别为（82.28±8.87）、（78.54±9.24）、（76.32±9.08）分，三者间差异有统计学意义（ F＝7.148，P＝0.000）。重、中、轻度三者阳性、阴性量表总分间差异有统计学意义（ P﹤0.05）；其中，不同残疾水平者阳性量表中的妄想、夸大、猜疑/被害、敌对性，阴性量表中的抽象思维困难，一般精神病理量表中的焦虑、自罪感、冲动控制缺乏评分间差异有统计学意义（ P﹤0.05）。结论不同精神残疾程度的精神分裂症患者精神症状评分不同。精神分裂症患者的阳性、阴性症状可能与精神残疾程度有关，其中妄想、夸大、猜疑/被害、敌对性、抽象思维困难、焦虑、自罪感、冲动控制缺乏等更为明显。