Meyer H, Taiminen T, Vuori T, Aijälä A, Helenius H
Department of Psychology, Abo Akademi University, Turku, Finland.
J Nerv Ment Dis. 1999 Jun;187(6):343-52. doi: 10.1097/00005053-199906000-00003.
The aims of this study were: a) to assess the prevalence of posttraumatic stress disorder (PTSD) after an acute psychotic episode in schizophrenic and delusional patients, b) to explore which psychotic symptoms and aspects of treatment were associated with traumatization, and c) to compare the extent of the traumatic impact of psychosis and involuntary hospitalization. Forty-six schizophrenic and delusional patients were assessed with the Positive and Negative Syndrome Scale (PANSS), the Impact of Event Scale-Revised (IES-R), and the Clinician-Administered PTSD Scale (CAPS) at weeks 1 and 8 after acute psychiatric admission. Traumatic symptoms related to psychosis and coercive measures were scored separately. The prevalence of PTSD was found to be 11%. Sixty-nine percent of traumatic symptoms were related to psychosis and 24% to hospitalization. High PANSS score at week 8 was the strongest risk factor for the development of PTSD. Particularly positive and depressive/anxious symptomatology were associated with psychosis-related traumatic symptoms at both weeks 1 and 8. These data suggest that, in general, schizophrenic and delusional symptoms are more traumatic than the coercive measures used to control them.
a)评估精神分裂症和妄想症患者急性精神病发作后创伤后应激障碍(PTSD)的患病率;b)探究哪些精神病症状及治疗方面与创伤相关;c)比较精神病和非自愿住院的创伤影响程度。46名精神分裂症和妄想症患者在急性精神科入院后第1周和第8周接受了阳性和阴性症状量表(PANSS)、事件影响量表修订版(IES-R)以及临床医生施测的PTSD量表(CAPS)评估。与精神病和强制手段相关的创伤症状分别计分。结果发现PTSD的患病率为11%。69%的创伤症状与精神病相关,24%与住院相关。第8周时高PANSS评分是PTSD发生的最强危险因素。在第1周和第8周,特别是阳性症状以及抑郁/焦虑症状与精神病相关的创伤症状有关。这些数据表明,一般而言,精神分裂症和妄想症症状比用于控制这些症状的强制手段更具创伤性。