Ventura J, Nuechterlein K H, Subotnik K L, Hardesty J P, Mintz J
Department of Psychiatry, University of California, Los Angeles 90095-6968, USA.
J Abnorm Psychol. 2000 Feb;109(1):139-44.
Previous studies have linked life events with depression in chronic schizophrenia, but those studies had methodological limitations. Using a prospective research design and examining events that were clearly independent of the patients' illnesses, the authors sought to determine whether stressful life events could trigger depressive symptoms in the early course of schizophrenia. Schizophrenia patients (n = 99) were followed for 1 year from a point of outpatient stabilization. Life event interviews were conducted every 4 weeks and symptom assessments every 2 weeks. Survival analyses showed a significantly increased risk for an exacerbation of significant depressive symptoms following an independent life event. Of interest is that an analysis of competing risk showed that the odds of psychotic exacerbation following a major independent life event were not significantly greater than the odds of depressive exacerbation. The risk of depression and of psychosis after experiencing a stressful life event is significantly increased for the first month, but the risk period can extend to 3 months.
以往的研究已将生活事件与慢性精神分裂症患者的抑郁联系起来，但这些研究存在方法学上的局限性。作者采用前瞻性研究设计，研究与患者疾病明显无关的事件，试图确定应激性生活事件是否会在精神分裂症病程早期引发抑郁症状。对99名精神分裂症患者在门诊病情稳定后进行了为期1年的随访。每4周进行一次生活事件访谈，每2周进行一次症状评估。生存分析显示，独立生活事件后出现显著抑郁症状加重的风险显著增加。有趣的是，一项竞争风险分析表明，重大独立生活事件后精神病性症状加重的几率并不显著高于抑郁加重的几率。经历应激性生活事件后，抑郁和精神病发作的风险在第一个月显著增加，但风险期可延长至3个月。
