Siu Cynthia O, Harvey Philip D, Agid Ofer, Waye Mary, Brambilla Carla, Choi Wing-Kit, Remington Gary
COS Consulting, Montreal, QC, Canada.
University of Miami Miller School of Medicine, Miami, FL, USA; Research Service, Bruce W. Carter VA Medical Center, Miami, FL, USA.
Schizophr Res Cogn. 2015 Sep 1;2(3):127-132. doi: 10.1016/j.scog.2015.05.002. Epub 2015 Jun 9.
Lack of insight is a well-established phenomenon in schizophrenia, and has been associated with reduced rater-assessed functional performance but increased self-reported well-being in previous studies. The objective of this study was to examine factors that might influence insight (as assessed by the Insight and Treatment Attitudes Questionnaire [ITAQ] or PANSS item G12) and subjective quality-of-life (as assessed by Lehman QoL Interview [LQOLI]), using the large National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) dataset. Uncooperativeness was assessed by PANSS item G8 ("Uncooperativeness"). In the analysis, we found significant moderating effects for insight on the relationships of subjective life satisfaction assessment to symptom severity (as assessed by CGI-S score), objective everyday functioning (as assessed by rater-administered Heinrichs-Carpenter Quality of Life scale), clinically rated uncooperativeness (as assessed by PANSS G8), and discontinuation of treatment for all causes (all P > 0.05 for statistical interaction between insight and subject QoL). Patients with chronic schizophrenia who reported being "pleased" or "delighted" on LQOLI were found to have significantly lower neurocognitive reasoning performance and poorer insight (ITAQ total score). Our findings underscore the importance of reducing cognitive and insight impairments for both treatment compliance and improved functional outcomes.
缺乏自知力是精神分裂症中一种公认的现象,在以往研究中,它与评估者评定的功能表现降低相关,但与自我报告的幸福感增加有关。本研究的目的是利用美国国立精神卫生研究所大型干预有效性临床抗精神病药物试验(CATIE)数据集,研究可能影响自知力(通过自知力与治疗态度问卷[ITAQ]或阳性和阴性症状量表项目G12评估)和主观生活质量(通过雷曼生活质量访谈[LQOLI]评估)的因素。不合作性通过阳性和阴性症状量表项目G8(“不合作性”)进行评估。在分析中,我们发现自知力对主观生活满意度评估与症状严重程度(通过临床总体印象量表严重程度得分[CGI-S]评估)、客观日常功能(通过评估者实施的海因里希斯-卡彭特生活质量量表评估)、临床评定的不合作性(通过阳性和阴性症状量表G8评估)以及所有原因导致的治疗中断之间的关系具有显著的调节作用(自知力与受试者生活质量之间的统计交互作用所有P>0.05)。在LQOLI中报告“满意”或“高兴”的慢性精神分裂症患者被发现具有显著更低的神经认知推理表现和更差的自知力(ITAQ总分)。我们的研究结果强调了减少认知和自知力损害对于治疗依从性和改善功能结局的重要性。