Department of Psychiatry, Faculty of Medicine, Kuwait University, Safat, Kuwait. zahid @ hsc.edu.kw
Psychopathology. 2010;43(6):345-56. doi: 10.1159/000320349. Epub 2010 Aug 25.
The heterogeneity of schizophrenia psychopathology has led to a search for symptom clusters that could be related to broad features of the disease. The objectives of the study were to: (1) highlight the pattern of symptoms among Kuwaiti subjects with schizophrenia, using the ICD-10 symptom checklist; (2) assess the factor structure of the Brief Psychiatric Rating Scale 18 (BPRS-18) and BPRS-24, and (3) evaluate the relationship of the resulting factors with sociodemographic characteristics, age at onset of illness, family history of mental illness, objective indicators of quality of life, self-esteem, affect balance, family caregiver burden, patient's perceptions of service satisfaction and needs for care.
Consecutive outpatients in stable condition were assessed with the BPRS and ICD-10 symptom checklist, as well as measures of quality of life, needs for care, service satisfaction and family caregiver burden.
There were 130 patients (66.1% men, mean age = 36.8 years, age at onset of illness = 24.2 years, duration of illness = 12.9 years). Of the ICD-10 symptoms, the commonest positive symptoms were hallucinations (58.5%) and delusions (72%). Catatonic symptoms were rare (2.9%). About a quarter of the subjects experienced 4 of the negative symptoms. In exploratory factor analysis, we broadly replicated the known syndromes for BPRS-24 (disorganization, positive, activation, manic, negative and depression) and BPRS-18 (negative, positive, activation and affect). In regression analyses, the variables independently associated with psychopathology were family income, negative affect, self-esteem, duration of illness, age, lack of money for enjoyment, met needs for care and caregiver tension. The negative syndrome had more significant associations with the variables investigated than the positive syndrome. Psychopathological scores were separable from indices of psychological well-being.
In this first study of schizophrenia psychopathology from the Arab world, the clinical manifestations were similar to the data from the developed countries. The persistence of psychotic symptoms despite freely available antipsychotic treatment and the impact on caregiver burden call for attention to the perennial issue of treatment resistance and underscore the need for continued interaction with family members after the acute inpatient phase of treatment, in order to address the impact of symptoms.
精神分裂症的病理学异质性导致人们寻找可能与疾病广泛特征相关的症状群。本研究的目的是：（1）使用 ICD-10 症状检查表，突出科威特精神分裂症患者的症状模式；（2）评估简明精神病评定量表 18（BPRS-18）和 BPRS-24 的因子结构；（3）评估得出的因子与人口统计学特征、发病年龄、精神病史、生活质量客观指标、自尊、情感平衡、家庭照顾者负担、患者对服务满意度和护理需求的关系。
对稳定状态下的连续门诊患者进行 BPRS 和 ICD-10 症状检查表评估，以及生活质量、护理需求、服务满意度和家庭照顾者负担的评估。
共有 130 名患者（66.1%为男性，平均年龄=36.8 岁，发病年龄=24.2 岁，病程=12.9 年）。ICD-10 症状中最常见的阳性症状是幻觉（58.5%）和妄想（72%）。紧张症症状很少见（2.9%）。约四分之一的患者经历了 4 种阴性症状。在探索性因子分析中，我们广泛复制了 BPRS-24（混乱、阳性、激活、躁狂、阴性和抑郁）和 BPRS-18（阴性、阳性、激活和情感）的已知综合征。在回归分析中，与精神病理学独立相关的变量是家庭收入、负性情绪、自尊、病程、年龄、缺乏娱乐资金、满足护理需求和照顾者紧张。阴性综合征与所研究的变量有更多显著的关联，而阳性综合征则没有。精神病理学评分与心理健康指数是可分离的。
在阿拉伯世界首次对精神分裂症病理学进行的这项研究中，临床表现与发达国家的数据相似。尽管有免费的抗精神病药物治疗，但仍存在精神病症状，以及对照顾者负担的影响，这引起了人们对治疗抵抗这一长期问题的关注，并强调需要在治疗急性住院阶段后继续与家庭成员互动，以解决症状的影响。
