Aggarwal Neil Krishan, Zhang Xiang Yang, Stefanovics Elina, Chen Da Chun, Xiu Mei Hong, Xu Ke, Rosenheck Robert A
Department of Psychiatry, Yale University, New Haven, CT, USA.
J Nerv Ment Dis. 2012 Sep;200(9):814-20. doi: 10.1097/NMD.0b013e318266bcaa.
This article compares Positive and Negative Syndrome Scale (PANSS) data from Chinese and American inpatients with chronic schizophrenia to show how differences in item ratings may reflect cultural attitudes of raters. The Chinese sample (N = 504) came from Beijing Huilongguan Hospital. The American sample came from 268 PANSS assessments of Clinical Antipsychotic Trials of Intervention Effectiveness subjects hospitalized for 15 days or more to optimize equivalence of the samples. When controlling for age and sex, the Chinese sample scored significantly lower for total score by 25% (p < 0.0001), for the positive subscale by 35% (p < 0.0001), and on the general subscale by 32% (p < 0.0001) but not significantly different on the negative subscale score (+0.26%; p = 0.76). However, the Chinese sample scored 26% higher on the item on poor rapport (p < 0.0001), 10.2% higher on passive social withdrawal (p = 0.003), and most notably 46% higher on the item on lack of judgment and insight (p < 0.0001). These results remain broadly consistent across sex subgroup analyses. Differences seem to be best explained by both cultural differences in patient clinical presentations and varying American and Chinese cultural values affecting rater judgment.
本文比较了中国和美国慢性精神分裂症住院患者的阳性与阴性症状量表（PANSS）数据，以展示条目评分差异如何反映评分者的文化态度。中国样本（N = 504）来自北京回龙观医院。美国样本来自对干预有效性临床抗精神病药物试验中住院15天或更长时间的受试者进行的268次PANSS评估，以优化样本的等效性。在控制年龄和性别后，中国样本的总分显著低25%（p < 0.0001），阳性分量表低35%（p < 0.0001），一般分量表低32%（p < 0.0001），但阴性分量表得分无显著差异（+0.26%；p = 0.76）。然而，中国样本在关系不良条目上得分高26%（p < 0.0001），在被动社交退缩条目上高10.2%（p = 0.003），最显著的是在缺乏判断力和洞察力条目上高46%（p < 0.0001）。这些结果在性别亚组分析中大体保持一致。差异似乎最好由患者临床表现的文化差异以及影响评分者判断的中美文化价值观差异来解释。
