Department of Neuropsychiatry, Keio University, School of Medicine, Tokyo, Japan.
Compr Psychiatry. 2012 Oct;53(7):946-51. doi: 10.1016/j.comppsych.2012.03.002. Epub 2012 May 2.
Remitted schizophrenic patients living in the community often encounter difficulties in their daily lives, possibly leading to the development of social anxiety symptoms. Although several studies have reported the significance of social anxiety as a comorbidity in patients with schizophrenia, few longitudinal data are available on the development of social anxiety symptoms in patients with remitted schizophrenia, especially in association with the process of "deinstitutionalization." The aims of this study were to assess the social anxiety symptoms in remitted outpatients with schizophrenia and to examine whether the development of social anxiety symptoms was associated with psychotic symptoms, social functioning, or subjective quality of life.
Fifty-six people with schizophrenia who were discharged through a deinstitutionalization project were enrolled in this longitudinal study and prospectively assessed with regard to their symptoms, social functioning, and subjective quality of life. The severity of social anxiety symptoms was measured using the Liebowitz Social Anxiety Scale (LSAS). Global/Social functioning and subjective quality of life were evaluated using the Global Assessment of Functioning Scale, the Social Functioning Scale, and the World Health Organization-Quality of Life 26 (WHO-QOL26).
Thirty-six patients completed the reassessment at the end of the 5-year follow-up period. The mean LSAS total score worsened over time, whereas other symptoms improved from the baseline. The mean WHO-QOL26 score in the worsened LSAS group was significantly lower than that in the stable LSAS group. At baseline, WHO-QOL26 scores were associated with an increase in the severity of social anxiety symptoms.
In community-dwelling patients with remitted schizophrenia, a lower subjective quality of life might lead to the development of social anxiety symptoms, both concurrently and prospectively. To achieve a complete functional recovery, additional interventions for social anxiety may be needed.
缓解期精神分裂症患者在社区中经常遇到日常生活困难，可能导致出现社交焦虑症状。尽管有几项研究报告了社交焦虑作为精神分裂症患者共病的重要性，但缓解期精神分裂症患者社交焦虑症状的发展，特别是与“去机构化”过程相关的发展，很少有纵向数据。本研究旨在评估缓解期精神分裂症门诊患者的社交焦虑症状，并探讨社交焦虑症状的发展是否与精神病症状、社会功能或主观生活质量有关。
本纵向研究纳入了 56 名通过去机构化项目出院的精神分裂症患者，并对其症状、社会功能和主观生活质量进行了前瞻性评估。采用 Liebowitz 社交焦虑量表（LSAS）评估社交焦虑症状的严重程度。使用总体功能评估量表、社会功能量表和世界卫生组织生活质量量表 26 版（WHO-QOL26）评估总体/社会功能和主观生活质量。
36 名患者在 5 年随访结束时完成了重新评估。LSAS 总分随时间推移而恶化，而其他症状则从基线开始改善。LSAS 恶化组的平均 WHO-QOL26 评分显著低于 LSAS 稳定组。在基线时，WHO-QOL26 评分与社交焦虑症状严重程度的增加相关。
在社区居住的缓解期精神分裂症患者中，较低的主观生活质量可能导致社交焦虑症状的出现，无论是同时出现还是前瞻性出现。为了实现完全的功能恢复，可能需要额外的社交焦虑干预措施。
