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[精神分裂症与单侧脑损伤中的情感行为。大脑半球不对称性。第一部分]

[Emotional behavior in schizophrenia and one-sided brain damage. Cerebral hemispheric asymmetry. Part I].

作者信息

Kucharska-Pietura Katarzyna, Hunca-Bednarska Anna

机构信息

Katedry i Kliniki Psychiatrii AM w Lublinie.

出版信息

Psychiatr Pol. 2002 May-Jun;36(3):421-34.

Abstract

Although, emotions play a crucial role in schizophrenia, the changes in emotional dimension in relation to brain asymmetry still remain controversial. The aim of our work was: 1) to compare the emotional behaviour between the examined groups: S--non-chronic schizophrenic patients (n = 50), CS--chronic schizophrenic patients (n = 50), N--healthy controls (n = 50), R--right brain-damaged patients (n = 30), and L--left brain-damaged patients (n = 30), 2) to assess the changes in attitude processes and in types of emotional reactions, its relation to lateralised hemisphere damage and chronicity of the schizophrenic process. All psychiatric subjects were diagnosed as paranoid schizophrenics according to DSM-IV criteria and were scored on the PANSS scale after four weeks of neuroleptic treatment. Brain-damaged patients were included if they experienced single-episode cerebrovascular accidents causing right or left hemisphere damage (confirmed in CT scan reports). The neurological patients were examined at least 3 weeks after the onset of the episode. Emotional behaviour was assessed using Observational Scale of Emotional Behaviour aimed at the evaluation of: A) attitude processes B) the emotional reactions. Our results revealed differentiated type of emotional behaviour in the examined population. Right brain-damaged patients significantly often revealed elevated mood, lack of adequacy of self-evaluation and active or negative attitude towards the environment. Left brain-damaged patients showed depressed mood, resignation, positive or seldom passive attitude to others and adequate self-evaluation. Schizophrenic patients mostly revealed indifferent mood and passive attitude to environment, their self-evaluation was rather adequate. Based on our data, the changes in emotional behaviour in schizophrenic patients might reflect frontal lobes dysfunction rather than dysfunction localised in one of cerebral hemispheres.

摘要

尽管情绪在精神分裂症中起着至关重要的作用,但与大脑不对称相关的情绪维度变化仍然存在争议。我们研究的目的是:1)比较被检查组之间的情绪行为:S组——非慢性精神分裂症患者(n = 50),CS组——慢性精神分裂症患者(n = 50),N组——健康对照组(n = 50),R组——右脑损伤患者(n = 30),以及L组——左脑损伤患者(n = 30);2)评估态度过程和情绪反应类型的变化,及其与半球侧化损伤和精神分裂症病程慢性化的关系。所有精神科受试者均根据DSM-IV标准被诊断为偏执型精神分裂症,并在接受四周抗精神病药物治疗后使用阳性和阴性症状量表(PANSS)进行评分。如果脑损伤患者经历了导致右半球或左半球损伤的单次脑血管意外(CT扫描报告证实),则将其纳入研究。神经科患者在发病后至少3周接受检查。使用情绪行为观察量表评估情绪行为,该量表旨在评估:A)态度过程;B)情绪反应。我们的研究结果显示,被检查人群的情绪行为类型存在差异。右脑损伤患者经常显著表现出情绪高涨、自我评估不足以及对环境的积极或消极态度。左脑损伤患者表现出情绪低落、顺从、对他人积极或很少消极的态度以及充分的自我评估。精神分裂症患者大多表现出冷漠的情绪和对环境的消极态度,他们的自我评估较为充分。根据我们的数据,精神分裂症患者情绪行为的变化可能反映额叶功能障碍,而非局限于某一个脑半球的功能障碍。

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