Tan Eric J, Thomas Neil, Rossell Susan L
Monash Alfred Psychiatry research centre, Monash University Central Clinical School, and The Alfred Hospital, Melbourne, Australia.
Monash Alfred Psychiatry research centre, Monash University Central Clinical School, and The Alfred Hospital, Melbourne, Australia; Brain and Psychological Sciences Research Centre, Swinburne University of Technology, Hawthorn, Australia.
Compr Psychiatry. 2014 Apr;55(3):693-8. doi: 10.1016/j.comppsych.2013.10.016. Epub 2013 Nov 7.
Speech disturbances in schizophrenia impact on the individual's communicative ability. Although they are considered a core feature of schizophrenia, comparatively little work has been done to examine their impact on the life experiences of patients. This study aimed to examine the relationship between schizophrenia speech disturbances, including those traditionally known as formal thought disorder (TD), and quality of life (QoL). It assessed effects on functioning (objective QoL) and satisfaction (subjective QoL) concurrently, while controlling for the influence of neurocognition and depression. Fifty-four patients with schizophrenia/schizoaffective disorder were administered the MATRICS Consensus Cognitive Battery (MCCB), the PANSS, MADRS (with separate ratings for negative TD [verbal underproductivity] and positive TD [verbal disorganisation and pressured speech]) and Lehman's QOLI assessing both objective and subjective QoL. Ratings of positive and negative TD, depression, and general neurocognition were entered into hierarchical regressions to explore their relationship with both life functioning and satisfaction. Verbal underproductivity was a significant predictor of objective QoL, while pressured speech had a trend association with subjective QoL. This suggests a differential relationship between speech disturbances and QoL. Verbal underproductivity seems to affect daily functioning and relations with others, while pressured speech is predictive of satisfaction with life. The impact of verbal underproductivity on QoL suggests it to be an important target for rehabilitation in schizophrenia.
精神分裂症中的言语障碍会影响个体的沟通能力。尽管它们被认为是精神分裂症的核心特征，但相对而言，很少有研究致力于考察其对患者生活体验的影响。本研究旨在探讨精神分裂症言语障碍（包括传统上称为形式思维障碍（TD）的那些障碍）与生活质量（QoL）之间的关系。它在控制神经认知和抑郁影响的同时，同时评估了对功能（客观生活质量）和满意度（主观生活质量）的影响。对54名精神分裂症/分裂情感性障碍患者进行了MATRICS共识认知成套测验（MCCB）、阳性和阴性症状评定量表（PANSS）、蒙哥马利-阿斯伯格抑郁评定量表（MADRS，对阴性TD[言语产出减少]和阳性TD[言语紊乱和言语急迫]分别进行评分）以及评估客观和主观生活质量的莱曼生活质量问卷（QOLI）。将阳性和阴性TD、抑郁及一般神经认知的评分纳入分层回归，以探讨它们与生活功能和满意度之间的关系。言语产出减少是客观生活质量的显著预测因素，而言语急迫与主观生活质量有一定的关联趋势。这表明言语障碍与生活质量之间存在差异关系。言语产出减少似乎会影响日常功能以及与他人的关系，而言语急迫则可预测对生活的满意度。言语产出减少对生活质量的影响表明它是精神分裂症康复的一个重要目标。
