Salokangas Raimo K R, Honkonen Teija, Stengård Eija, Koivisto Aanna-Maija
Department of Psychiatry, University of Turku, Turku University Central Hospital, FI-20520 Turku, Finland.
Nord J Psychiatry. 2002;56(5):319-27. doi: 10.1080/080394802760322079.
National representative samples of 1571 schizophrenia patients discharged from mental hospitals in Finland in 1990 and 1994 were interviewed 3 years after discharge. The symptom items assessed by the PANSS were factorized and orthogonal rotations were performed. Five factor dimensions, negative, positive, depressive, hostile and disorganization dimension, were obtained and correlated with data of patients' socio-demographic background, clinical history, condition and outcome. The negative dimension was more prominent in male and single patients, the depressive dimension in female and divorced patients. Patients with early onset and long duration of illness had high disorganization scores. Patients with disorganized subtype of schizophrenia had high scores in positive and disorganization dimensions. High scores in all, especially in negative and positive dimensions, were associated with poor psychosocial situation. Symptom dimensions varied also according to treatment setting at follow-up. Symptom dimensions of long-term schizophrenia patients in the community are closely associated with patients' socio-demographic background, clinical history and conditions, as well as with outcome and the treatment patients receive. A dimensional approach, instead of a categorical one, seems to be important in assessing symptomatology and its relation to outcome and interventions in schizophrenia.
对1990年和1994年从芬兰精神病院出院的1571名精神分裂症患者的全国代表性样本在出院3年后进行了访谈。对阳性和阴性症状评定量表(PANSS)评估的症状项目进行因子分析并进行正交旋转。获得了五个因子维度,即阴性、阳性、抑郁、敌对和紊乱维度,并将其与患者的社会人口学背景、临床病史、病情和结局数据进行关联。阴性维度在男性和单身患者中更为突出,抑郁维度在女性和离异患者中更为突出。起病早且病程长的患者紊乱得分较高。精神分裂症紊乱亚型的患者在阳性和紊乱维度上得分较高。所有维度得分高,尤其是阴性和阳性维度得分高,与不良的社会心理状况相关。症状维度在随访时也因治疗环境而异。社区中长期精神分裂症患者的症状维度与患者的社会人口学背景、临床病史和病情密切相关,也与结局和患者接受的治疗相关。在评估精神分裂症的症状学及其与结局和干预措施的关系时,采用维度方法而非分类方法似乎很重要。