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跨诊断样本中精神病障碍患者的听觉幻觉:描述性、横断面研究。

Auditory hallucinations in a cross-diagnostic sample of psychotic disorder patients: a descriptive, cross-sectional study.

机构信息

Schizophrenia and Bipolar Disorder Program, McLean Hospital and Harvard Medical School, Department of Psychiatry, USA.

出版信息

Compr Psychiatry. 2012 Aug;53(6):718-26. doi: 10.1016/j.comppsych.2011.11.003. Epub 2011 Dec 22.

Abstract

BACKGROUND

Auditory hallucinations (AH) are a cardinal feature of schizophrenia spectrum disorders. They are not disease specific, however, and can occur in other conditions, including affective psychoses.

METHODS

In this descriptive, cross-sectional study, we examined AH in relation to other psychotic symptoms, mood symptoms, illness severity, and functional status in 569 patients with psychosis (n = 172 schizophrenia, n = 153 schizoaffective disorder, n = 244 bipolar disorder with psychotic features).

RESULTS

A total of 323 (56.7%) patients reported a lifetime history of AH (75.6% of patients with schizophrenia, 71.9% schizoaffective disorder, and 34.0% bipolar disorder). The mean score for the hallucinations item (P3) of the Positive and Negative Syndrome Scale in the AH group was 3.66 ± 1.79, indicating mild to moderate state hallucinations severity. Auditory hallucinations were strongly associated with hallucinations in other sensory modalities and with the first-rank symptoms of delusions of control, thought insertion, and thought broadcasting. Multivariate analysis showed that AH were associated with lower education even after controlling for diagnosis, age, and sex. There was no association between AH and functional status as measured by the Multnomah Community Ability Scale.

CONCLUSIONS

Auditory hallucinations are associated with specific clinical features across the continuum of both schizophrenic and affective psychoses independent of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnosis.

摘要

背景

幻听(AH)是精神分裂症谱系障碍的主要特征。然而,它并不是特定疾病的表现,也可能发生在其他疾病中,包括情感性精神病。

方法

在这项描述性、横断面研究中,我们在 569 名精神病患者(172 名精神分裂症患者、153 名分裂情感性障碍患者、244 名有精神病特征的双相情感障碍患者)中,检查了幻听与其他精神病症状、情绪症状、疾病严重程度和功能状态的关系。

结果

共有 323 名(56.7%)患者报告有幻听的终生病史(75.6%的精神分裂症患者、71.9%的分裂情感性障碍患者和 34.0%的有精神病特征的双相情感障碍患者)。在有幻听的患者组中,阳性和阴性症状量表(PANSS)的幻听项目(P3)的平均得分为 3.66±1.79,表明幻听的严重程度为轻度至中度。幻听与其他感觉模态的幻觉以及妄想的一级症状(控制妄想、思维插入和思维广播)密切相关。多变量分析表明,即使在控制了诊断、年龄和性别后,幻听仍与受教育程度较低有关。幻听与 Multnomah 社区能力量表(MCS)所测量的功能状态之间没有关联。

结论

幻听与精神分裂症和情感性精神病连续体中的特定临床特征相关,而与《精神障碍诊断与统计手册》第四版的诊断无关。

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