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精神分裂症中特质性或状态性快感缺乏与精神分裂症症状之间的稳定性及关系:一项13年的随访研究

Stability and relationships between trait or state anhedonia and schizophrenic symptoms in schizophrenia: a 13-year follow-up study.

作者信息

Loas Gwenolé, Monestes Jean Louis, Ingelaere Audrey, Noisette Carole, Herbener Ellen S

机构信息

Service Universitaire de Psychiatrie, CNRS-UMR 8160 and CHU d'Amiens, 80044 Amiens cedex 01, France.

出版信息

Psychiatry Res. 2009 Apr 30;166(2-3):132-40. doi: 10.1016/j.psychres.2008.02.010. Epub 2009 Mar 9.

Abstract

The aim of the present study was to explore the stability of anhedonia and its relationships with schizophrenic symptoms across a 13-year study period. We tested the hypothesis that trait anhedonia, rated by the Physical Anhedonia Scale (PAS), was stable and independent of schizophrenic symptoms across this period, while measures of state anhedonia were not. Sixty schizophrenic subjects were evaluated at two time points, at hospital admission or during an ambulatory psychiatric consultation and 13 years later. Trait anhedonia was assessed using the Chapman Physical Anhedonia Scale, while state anhedonia was assessed with a subscale extracted from the Beck Depression Inventory. The Positive and Negative Syndrome Scale (PANSS) was used to rate schizophrenic symptomatology. Unlike trait anhedonia, state anhedonia decreased significantly over time. Based on results from multiple regressions, negative and depressive dimensions were significant predictors of state anhedonia. Trait anhedonia was not associated with negative symptoms, but was associated with severity of disorganization symptoms at baseline and with our state measure of anhedonia at follow-up. In the current study, state and trait anhedonia were correlated, but depressive symptoms in general were not associated with physical anhedonia. The results indicated that trait anhedonia, in contrast to state anhedonia, had absolute stability, was independent of the negative dimension, as measured by the PANSS, of schizophrenic symptomatology and correlated with specific aspects of depressive anhedonia.

摘要

本研究的目的是在13年的研究期间探讨快感缺失的稳定性及其与精神分裂症症状的关系。我们检验了以下假设:通过躯体快感缺失量表(PAS)评定的特质性快感缺失在这一时期是稳定的,且独立于精神分裂症症状,而状态性快感缺失的测量结果并非如此。60名精神分裂症患者在两个时间点接受评估,一是入院时或门诊精神科会诊时,二是13年后。特质性快感缺失采用查普曼躯体快感缺失量表进行评估,而状态性快感缺失则通过从贝克抑郁量表中提取的一个分量表进行评估。阳性和阴性症状量表(PANSS)用于评定精神分裂症症状。与特质性快感缺失不同,状态性快感缺失随时间显著下降。基于多元回归结果,阴性和抑郁维度是状态性快感缺失的显著预测因子。特质性快感缺失与阴性症状无关,但与基线时的紊乱症状严重程度以及随访时的状态性快感缺失测量结果相关。在本研究中,状态性和特质性快感缺失相关,但一般抑郁症状与躯体快感缺失无关。结果表明,与状态性快感缺失相反,特质性快感缺失具有绝对稳定性,独立于通过PANSS测量的精神分裂症症状的阴性维度,并且与抑郁性快感缺失的特定方面相关。

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