首发及慢性精神分裂症患者自知力影响因素分析

摘要

Objective:To explore the influencing factors on insight in patients with first-episode and chronic schizophrenia. Method:The demographic and clinical data of first-episode group(46 first-episode inpatients with schizophrenia)and chronic group(140 inpatients with chronic schizophrenia)were collected. All of the patients were assessed by positive and negative syndrome scale(PANSS)and insight and treatment attitudes questionnaire(ITAQ)at the day of admission and discharge. Analyze the influencing factors on in-sight. Results:There were significant differences on age,duration of illness,current length of stay between the two groups( P ﹤ 0. 05). There were no significant differences on scores of PANSS before treatment and its change values before and after treatment. Before treatment ITAQ scores in the first-episode group was significant-ly lower than the chronic group(P ﹤ 0. 01);but its change values before and after treatment between the two groups showed no significant difference. With ITAQ score change value of the dependent variable,the change values of symptoms of positive and negative points of PANSS,length of hospital stay,ITAQ score of before treatment in the first-episode group were entered the regression model(P ﹤ 0. 05 or P ﹤ 0. 001);the change values of symptoms of positive and negative points of PANSS,ITAQ score of before treatment in the chronic group were entered the regression model(all P ﹤ 0. 01). Conclusion:The main influencing factors on insight in patients with schizophrenia is management of clinical symptoms. Prolonging length of hospital stay maybe helpful to recover the insight in first-episode patients with schizophrenia.%目的：探讨首发和慢性精神分裂症患者自知力的影响因素。方法：46例首次发病精神分裂症患者（首发组）及140例慢性精神分裂症患者（慢性组）的人口学及临床资料，并分别于入院及出院时进行阳性与阴性症状量表（PANSS）和自知力与治疗态度问卷（ITAQ）评估；分析影响患者自知力的因素。结果：首发组年龄、病程及本次住院时间与慢性组比较差异有统计学意义（P 均﹤0.05）；两组治疗前 PANSS 评分及治疗前后 PANSS 评分变化值比较差异无统计学意义；治疗前 ITAQ 总分首发组明显低于慢性组（P ﹤0.01）；治疗后两组间 ITAQ 变化值比较差异无统计学意义。以 ITAQ 评分变化值为因变量，首发组 PANSS 中阳性症状及阴性症状分变化值、住院时间及治疗前的自知力进入回归模型（P ﹤0.05或 P ﹤0.001）；慢性组中患者治疗前的自知力及 PANSS 中阴性症状和阳性症状评分变化值进入回归模型（P 均﹤0.01）。结论：控制临床症状是改善首发和慢性精神分裂症患者自知力的主要影响因素；适当延长住院时间可能有助于首发患者自知力恢复。