Lindström Eva, Jedenius Erik, Levander Sten
Department of Neuroscience-Psychiatry, Uppsala University Hospital, Sweden.
Nord J Psychiatry. 2009;63(5):368-74; suppl 1-4. doi: 10.1080/08039480902807298.
The objective of the study was to validate a self-administrated symptom rating scale for use in patients with schizophrenia spectrum disorders by item analysis, exploration of factor structure, and analyses of reliability and validity. Data on 151 patients, initially treated by risperidone, obtained within the framework of a naturalistic Phase IV longitudinal study, were analysed by comparing patient and clinician ratings of symptoms, side-effects and global indices of illness. The Symptom Self-rating Scale for Schizophrenia (4S) is psychometrically adequate (item analysis, internal consistency, factor structure). Side-effect ratings were reliable. Symptom ratings displayed consistent associations with clinicians' ratings of corresponding symptom dimensions, suggesting construct validity. Patients had most difficulties assessing negative symptom items. Patients were well able to assess their own symptoms and drug side-effects. The factor structure of symptom ratings differs between patients and clinicians as well as how they construe global indices of illness. Clinicians focus on psychotic, patients on affective symptoms. Use of symptom self-ratings is one way to improve communication and thereby strengthen the therapeutic alliance and increase treatment adherence.
本研究的目的是通过项目分析、探索因子结构以及分析信度和效度，验证一种用于精神分裂症谱系障碍患者的自我管理症状评定量表。在一项自然主义的IV期纵向研究框架内，收集了151例最初接受利培酮治疗患者的数据，通过比较患者和临床医生对症状、副作用和疾病总体指标的评定进行分析。精神分裂症症状自评量表（4S）在心理测量学上是充分的（项目分析、内部一致性、因子结构）。副作用评定是可靠的。症状评定与临床医生对相应症状维度的评定显示出一致的关联，表明具有结构效度。患者在评估阴性症状项目时最困难。患者能够很好地评估自己的症状和药物副作用。患者和临床医生之间症状评定的因子结构不同，他们对疾病总体指标的理解方式也不同。临床医生关注精神病性症状，患者关注情感症状。使用症状自评是改善沟通的一种方式，从而加强治疗联盟并提高治疗依从性。
