Krupchanka Dzmitry, Katliar Mikhail
Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychiatry and Narcology, Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus;
Department of Human Perception, Cognition, and Action, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.
Schizophr Bull. 2016 May;42(3):600-7. doi: 10.1093/schbul/sbw024. Epub 2016 Mar 12.
There is evidence of a positive association between insight and depression among patients with schizophrenia. Self-stigma was shown to play a mediating role in this association. We attempted to broaden this concept by investigating insight as a potential moderator of the association between depressive symptoms amongst people with schizophrenia and stigmatizing views towards people with mental disorders in their close social environment.
In the initial sample of 120 pairs, data were gathered from 96 patients with a diagnosis of "paranoid schizophrenia" and 96 of their nearest relatives (80% response rate). In this cross-sectional study data were collected by clinical interview using the following questionnaires: "The Scale to Assess Unawareness of Mental Disorder," "Calgary Depression Scale for Schizophrenia," and "Brief Psychiatric Rating Scale." The stigmatizing views of patients' nearest relatives towards people with mental disorders were assessed with the "Mental Health in Public Conscience" scale.
Among patients with schizophrenia depressive symptom severity was positively associated with the intensity of nearest relatives' stigmatizing beliefs ("Nonbiological vision of mental illness," τ = 0.24; P < .001). The association was moderated by the level of patients' awareness of presence of mental disorder while controlling for age, sex, duration of illness and psychopathological symptoms.
The results support the hypothesis that the positive association between patients' depression and their nearest relatives' stigmatizing views is moderated by patients' insight. Directions for further research and practical implications are discussed.
有证据表明，精神分裂症患者的自知力与抑郁之间存在正相关。自我污名化在这种关联中起中介作用。我们试图通过研究自知力作为精神分裂症患者抑郁症状与他们在亲密社会环境中对精神障碍患者的污名化看法之间关联的潜在调节因素，来拓展这一概念。
在最初的120对样本中，收集了96名诊断为“偏执型精神分裂症”患者及其96名最近亲属的数据（应答率为80%）。在这项横断面研究中，通过临床访谈使用以下问卷收集数据：“精神障碍自知力评估量表”、“精神分裂症卡尔加里抑郁量表”和“简明精神病评定量表”。用“公众意识中的心理健康”量表评估患者最近亲属对精神障碍患者的污名化看法。
在精神分裂症患者中，抑郁症状严重程度与最近亲属污名化信念的强度呈正相关（“对精神疾病的非生物学看法”，τ = 0.24；P <.001）。在控制年龄、性别、病程和精神病理症状的同时，这种关联受患者对精神障碍存在的意识水平调节。
结果支持以下假设，即患者抑郁与其最近亲属污名化看法之间的正相关受患者自知力调节。讨论了进一步研究的方向和实际意义。
