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精神分裂症的阴性症状:综述

Negative symptoms in schizophrenia: a review.

作者信息

Mäkinen J, Miettunen J, Isohanni M, Koponen H

机构信息

Department of Psychiatry, University of Oulu, Finland.

出版信息

Nord J Psychiatry. 2008;62(5):334-41. doi: 10.1080/08039480801959307.

Abstract

Negative symptoms refer to the weakening or lack of normal thoughts, emotions or behaviour in schizophrenia patients. Their prevalence in first-episode psychosis is high, 50-90%, and 20-40% of schizophrenia patients have persisting negative symptoms. Severe negative symptoms during the early stages of treatment predict poor prognosis. The aim of the study was to review the current literature on the negative symptoms of schizophrenia. In June 2007, the following databases were searched: Web of Science, PubMed, PsycINFO, Medline (Ovid) and Scopus. The search included articles written in English and no time limit was determined. The studies were manually screened by one of the authors according to the title and abstract. About one in three schizophrenia patients suffer from significant negative symptoms. In these patients, negative symptoms constitute a key element of overall symptoms, weakening their ability to cope with everyday activities, affecting their quality of life and their ability to manage without significant outside help. About one in three schizophrenia patients suffer from significant negative symptoms. Attention should be focused on negative symptoms during the early phase of treatment, because they cause significant impairment to patients' quality of life. So far, no treatment appears to substantially improve negative symptoms narrowly defined. However, according to clinical experience, when treating negative symptoms, the best effect is achieved by optimizing the dose of medication and by complementing it with psychosocial therapies.

摘要

阴性症状是指精神分裂症患者正常思维、情感或行为的减弱或缺失。它们在首发精神病中的患病率很高,为50 - 90%,并且20 - 40%的精神分裂症患者存在持续性阴性症状。治疗早期的严重阴性症状预示着预后不良。本研究的目的是综述目前关于精神分裂症阴性症状的文献。2007年6月,检索了以下数据库:科学网、PubMed、PsycINFO、Medline(Ovid)和Scopus。检索包括用英文撰写的文章,且未设定时间限制。由一位作者根据标题和摘要对研究进行人工筛选。约三分之一的精神分裂症患者存在显著的阴性症状。在这些患者中,阴性症状是整体症状的关键要素,削弱了他们应对日常活动的能力,影响他们的生活质量以及在没有大量外部帮助的情况下自理的能力。约三分之一的精神分裂症患者存在显著的阴性症状。在治疗早期应关注阴性症状,因为它们会对患者的生活质量造成显著损害。到目前为止,尚无治疗方法能显著改善狭义上的阴性症状。然而,根据临床经验,在治疗阴性症状时,通过优化药物剂量并辅以心理社会治疗可取得最佳效果。

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