Département de Psychiatrie et neurosciences, Université Laval, Centre de Recherche de l׳Institut Universitaire en Santé Mentale de Québec, Canada, 2601 Chemin de la Canardière, Québec, QC G1J 2G3.
Département de Psychiatrie et neurosciences, Université Laval, Centre de Recherche de l׳Institut Universitaire en Santé Mentale de Québec, Canada, 2601 Chemin de la Canardière, Québec, QC G1J 2G3.
Psychiatry Res. 2015 May 30;227(1):39-45. doi: 10.1016/j.psychres.2015.02.017. Epub 2015 Mar 9.
Social anxiety disorder (SAD) represents a common comorbidity in schizophrenia, but questions remain regarding how this comorbidity is related to symptomatology and self-perceptions. Forty-two patients with recent-onset schizophrenia were evaluated for SAD, and assessed with the Positive and Negative Syndrome Scale (PANSS), as well as the Social Comparison Scale (SCS), which assessed how participants perceived themselves in relation with others (i.e., social rank). Eighteen patients met criteria for SAD (SZ+) while 24 patients did not (SZ-). Analysis of symptoms using a five-factor model of the PANSS revealed that the SZ- group had more severe symptoms than SZ+ on the Cognitive/Disorganization factor. Further analyses of individual symptoms demonstrated that the SZ- group was more affected in attention, abstract thinking, and cognitive disorganization (Cognitive/Disorganization symptoms), while the SZ+ group was more severely affected in anxiety, suspiciousness/persecution, and active social avoidance. Interestingly, severity of social anxiety symptom ratings correlated with certain PANSS symptoms only in the SZ- group. Perception of social rank, which was reduced in SZ+, displayed a trend level correlation with the positive symptoms in SZ-. Overall, the results suggest that SZ+ and SZ- may have different clinical profiles that could be important to consider when tailoring treatments for these patients.
社交焦虑障碍（SAD）在精神分裂症中是一种常见的共病，但关于这种共病与症状和自我认知的关系仍存在疑问。对 42 名新发精神分裂症患者进行了 SAD 评估，并使用阳性和阴性症状量表（PANSS）进行评估，以及社会比较量表（SCS），评估参与者如何将自己与他人进行比较（即社会等级）。18 名患者符合 SAD 标准（SZ+），而 24 名患者不符合（SZ-）。使用 PANSS 的五因素模型分析症状发现，SZ-组在认知/混乱因子上的症状比 SZ+组更严重。对个别症状的进一步分析表明，SZ-组在注意力、抽象思维和认知混乱（认知/混乱症状）方面受到的影响更大，而 SZ+组在焦虑、怀疑/迫害和主动社会回避方面受到的影响更严重。有趣的是，社交焦虑症状严重程度评分与某些 PANSS 症状仅在 SZ-组中相关。在 SZ+中降低的社会等级感知与 SZ-中的阳性症状呈趋势水平相关。总体而言，结果表明 SZ+和 SZ-可能具有不同的临床特征，在为这些患者量身定制治疗方案时，这可能是需要考虑的重要因素。
