系统家庭动力学特征对轻微精神病综合征患者临床结局的影响

摘要

目的:从系统家庭动力学视角探索家庭互动对轻微精神病综合征(APS)患者临床结局的影响. 方法:使用精神病风险症状量表(SOPS)和系统家庭动力学自评量表(SSFD)对63例APS患者进行精神病理学和系统家庭动力学评估;6个月后进行临床结局评定,分析系统家庭动力学特征对APS临床结局的影响. 结果:47例APS患者完成6个月的随访,其中8例(17.0%)转化,18例(38.3%)维持,21例(44.7%)恢复.3种结局状态的患者基线时的SSFD中"疾病观念"维度评分差异有统计学意义(F=4.17,P=0.022).方差分析模型显示,"疾病观念"维度每增加2.29分,APS患者在6个月内转化为精神病性障碍的可能性具有统计学意义(t=2.40,P=0.021). 结论:家庭成员的"疾病观念"可以预测APS患者6个月后的转化结局.%Objective:To explore the effect of systemic family dynamics on clinical outcomes in patients with attenuated psychosis syndrome(APS).Method:Sixty-three participants were identified as APS using the structured interview for psychosis-risk syndromes(SIPS) from 7 research centers.Participants were administered measures of systemic family dynamics(self-rating scale of systemic family dynamics,SSFD),and followed up 6 months later.Results:Of the 63 participants,47 of them were followed up.Among the 47 individuals,eight(17.0%) of them converted,18(38.3%) of them maintained the APS state and 21(44.7%) of them recovered.Among the three clinical outcomes,there were significant difference in the dimension of "disease concept"(F=4.17,P=0.022) in SSFD at baseline.Further variance model tests showed that the "disease concept" score increased by 2.29 points(t=2.40,P=0.021),then the probability of APS conversion was statistically significant.Conclusion:The disease concept of the family members could predict the conversion of the APS after 6 months.