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精神分裂症性障碍中幻听的临床维度

Clinical dimensions of auditory hallucinations in schizophrenic disorders.

作者信息

Oulis Panagiotis, Gournellis Rossetos, Konstantakopoulos George, Matsoukas Thomas, Michalopoulou Panagiota G, Soldatos Constantin, Lykouras Lefteris

机构信息

Department of Psychiatry, University of Athens, Eginition Hospital, 11528 Athens, Greece.

出版信息

Compr Psychiatry. 2007 Jul-Aug;48(4):337-42. doi: 10.1016/j.comppsych.2007.03.006. Epub 2007 May 24.

Abstract

BACKGROUND

Auditory hallucinations occupy, along with delusional beliefs, the center stage of active or "positive" psychotic clinical psychopathology. During the last decade, several sets of auditory hallucinations' clinical features were subjected to multivariate statistical analyses to disclose major dimensions of psychotic patients' overall hallucinatory experience and behavior. However, these studies failed, to a large extent, to provide satisfactory external validations of the thereby extracted factors.

METHODS

We investigated the major clinical dimensions of verbal auditory hallucinations in a sample of 100 inpatients with schizophrenic disorders. Patients (61 men and 39 women) were examined before the initiation of antipsychotic treatment and their assessment included 18 major clinical features of auditory hallucinations. Brief Psychiatric Rating Scale, Hamilton Depression Rating Scale, Global Assessment Scale, and Mini-Mental State Examination were used as external validators.

RESULTS

Principal component analysis resulted in the extraction of 5 factors interpreted as the dimensions of severity of auditory hallucinations, emotional and behavioral impact, rate of their intrusion in self-consciousness, delusional elaboration, and similarity to ordinary auditory perception, respectively. The second and third factors extracted in our study correlated with short duration of illness, whereas the first, fourth, and fifth ones correlated with chronicity. Our second factor correlated with clinical severity of patients' current mental state, the fifth factor with severity of their cognitive impairment, and the first and fourth ones with lower clinical depression despite patients' chronicity.

CONCLUSION

The findings of our study contribute to the further elucidation of the major clinical dimensions of auditory hallucinations and the testing of their external validity.

摘要

背景

幻听与妄想信念一起,在活跃性或“阳性”精神病性临床精神病理学中占据核心地位。在过去十年中,几组幻听的临床特征接受了多变量统计分析,以揭示精神病患者整体幻觉体验和行为的主要维度。然而,这些研究在很大程度上未能对由此提取的因素提供令人满意的外部验证。

方法

我们在100例精神分裂症住院患者样本中调查了言语幻听的主要临床维度。患者(61名男性和39名女性)在开始抗精神病治疗前接受检查,其评估包括幻听的18项主要临床特征。简易精神状态检查表、汉密尔顿抑郁量表、总体评估量表和简易精神状态检查被用作外部验证指标。

结果

主成分分析提取出5个因素,分别解释为幻听严重程度、情感和行为影响、其侵入自我意识的频率、妄想细化以及与普通听觉感知的相似性维度。我们研究中提取的第二个和第三个因素与病程短相关,而第一个、第四个和第五个因素与慢性病程相关。我们的第二个因素与患者当前精神状态的临床严重程度相关,第五个因素与他们认知障碍的严重程度相关,第一个和第四个因素与尽管病程长但临床抑郁程度较低相关。

结论

我们研究的结果有助于进一步阐明幻听的主要临床维度及其外部效度的检验。

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