Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
Psychiatry Res. 2012 Jan 30;195(1-2):39-44. doi: 10.1016/j.psychres.2011.07.009. Epub 2011 Jul 23.
Heightened stress sensitivity is a common characteristic of schizophrenia and may be predictive of clinical and functional outcomes. However, systematic assessment is not part of routine clinical practice. This study investigated the reliability and predictive values of two versions of a new scale for the assessment of psychological stress in psychosis (Psychological Stress Index; PSI). Thirty-seven patients with schizophrenia/schizoaffective disorder and 30 healthy controls completed a battery of self-report measures at baseline and 4-8 weeks for test-retest. Thirty-four patients were followed up at 12 months. Both of the 18-item and 9-item PSI demonstrated good levels of reliability and could significantly discriminate patients from healthy controls. Both versions showed moderate convergence with self-report and clinician ratings of depression and anxiety, and superior predictive validity of 12-month follow-up clinical and functional outcomes compared to an existing measure of stress (Perceived Stress Scale). The clinical usefulness of the PSI is supported by its predictive power on cross-sectional and longitudinal outcome. The PSI-9 performed as well as, if not better than, the PSI-18 in this study, but further evaluation is warranted for more conclusive comparison.
高度的应激敏感性是精神分裂症的一个常见特征，可能预测临床和功能结局。然而，系统评估并不是常规临床实践的一部分。本研究调查了一种新的精神病心理应激评估量表（心理应激指数；PSI）的两个版本的可靠性和预测值。37 名精神分裂症/分裂情感障碍患者和 30 名健康对照者在基线和 4-8 周时完成了一系列自我报告测量，用于测试-重测。34 名患者在 12 个月时进行了随访。18 项和 9 项 PSI 均表现出良好的可靠性，可显著区分患者和健康对照组。两个版本均与抑郁和焦虑的自我报告和临床医生评估中度相关，与现有的应激测量工具（感知压力量表）相比，具有更好的 12 个月随访临床和功能结局的预测有效性。PSI 的预测能力支持其在横断面和纵向结局中的临床应用。在本研究中，PSI-9 的表现与 PSI-18 一样好，如果不比 PSI-18 更好，则需要进一步评估以进行更具结论性的比较。
