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精神分裂症患者的分离症状:与儿童期创伤和精神病症状的关系。

Dissociative symptoms in patients with schizophrenia: relationships with childhood trauma and psychotic symptoms.

机构信息

Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.

出版信息

Compr Psychiatry. 2012 May;53(4):364-71. doi: 10.1016/j.comppsych.2011.05.010. Epub 2011 Jul 7.

Abstract

OBJECTIVE

This study sought to examine the stability of dissociative symptoms in patients with schizophrenia spectrum disorders as well as relationships between psychotic symptoms, childhood trauma, and dissociation.

METHOD

One hundred forty-five patients with schizophrenia spectrum disorders (72% schizophrenia, 67% men) were examined at admission to inpatient treatment and 3 weeks later using the Positive and Negative Syndrome Scale, the Childhood Trauma Questionnaire, and the Dissociative Experiences Scale.

RESULTS

Dissociative symptoms significantly decreased over time (mean, 19.2 vs 14.1; P < .001). The best predictor of dissociative symptoms at admission was the Positive and Negative Syndrome Scale positive subscale (F(inc)(3,64) = 3.66, P = .017), whereas childhood sexual abuse best predicted dissociation when patients were stabilized (F(inc)(10,80) = 2.00, P = .044).

CONCLUSION

Dissociative symptoms in patients with schizophrenia spectrum disorders are related to childhood trauma. Dissociation seems to be state dependent in this diagnostic group. Moreover, diagnostic interviews, in addition to the Dissociative Experiences Scale, should be considered to avoid measurement artifacts.

摘要

目的

本研究旨在考察精神分裂症谱系障碍患者的分离症状的稳定性,以及精神症状、儿童期创伤与分离之间的关系。

方法

对 145 名精神分裂症谱系障碍患者(72%为精神分裂症,67%为男性)在入院接受住院治疗时以及 3 周后使用阳性和阴性综合征量表、儿童期创伤问卷和分离体验量表进行评估。

结果

分离症状随时间显著下降(均值,19.2 比 14.1;P<0.001)。入院时分离症状的最佳预测因子是阳性和阴性综合征量表阳性分量表(F(inc)(3,64)=3.66,P=0.017),而当患者病情稳定时,童年性虐待最能预测分离(F(inc)(10,80)=2.00,P=0.044)。

结论

精神分裂症谱系障碍患者的分离症状与儿童期创伤有关。在该诊断组中,分离似乎是状态依赖性的。此外,除了分离体验量表外,还应考虑使用诊断访谈,以避免测量偏倚。

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