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精神分裂症和其他精神病中的洞察力和性别。

Insight and gender in schizophrenia and other psychoses.

机构信息

Mental Health Department, Corporació Sanitària Parc Taulí, Hospital Universitari - UAB Sabadell, Barcelona, Catalonia, Spain; Department of Psychiatry and Forensic Medicine. Universitat Autònoma de Barcelona Bellaterra, Barcelona, Catalonia, Spain; Research Workgroup on Womens' Mental Health, Catalan Society of Psychiatry & Mental Health Barcelona, Catalonia, Spain.

Research Workgroup on Womens' Mental Health, Catalan Society of Psychiatry & Mental Health Barcelona, Catalonia, Spain; Department of Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico.

出版信息

Psychiatry Res. 2016 Sep 30;243:268-77. doi: 10.1016/j.psychres.2016.04.089. Epub 2016 Jun 16.

Abstract

This study aimed to evaluate gender differences in the deficit of insight in psychosis and determine influences of clinical, functional, and sociodemographic variables. A multicenter sample of 401 adult patients with schizophrenia and other psychotic disorders who agreed to participate was evaluated in four centers of the metropolitan area of Barcelona (Catalonia). Psychopathological assessment was performed using the Positive and Negative Syndrome Scale Lindenmayers' Factors. Insight and its dimensions were assessed by means of the Scale of Unawareness of Mental Disorder. Significant differences were apparent neither between men and women in the three dimensions of insight, nor in the total awareness, nor in the total attribution subscales. However, statistically significant differences were found in awareness and attribution of particular symptoms. Women showed a worse awareness of thought disorder and alogia and a higher misattribution of apathy. Higher cognitive and positive symptoms, early stage of the illness, and having been married explained deficits of insight dimensions in women. In men, other variables such as lower functioning, higher age, other psychosis diagnosis, and, to a lower extent, higher scores in cognitive, positive, and excitative symptoms, explained deficits of insight dimensions. These data could help to design gender-specific preventive and therapeutic strategies.

摘要

本研究旨在评估精神分裂症等精神病患者中洞察力缺陷的性别差异,并确定临床、功能和社会人口学变量的影响。在巴塞罗那大都市区的四个中心评估了一个由 401 名成年精神分裂症和其他精神病患者组成的多中心样本,他们同意参与。使用 Lindenmayers 因素的阳性和阴性综合征量表进行精神病理学评估。使用精神障碍意识障碍量表评估洞察力及其维度。在洞察力的三个维度、总意识和总归因分量表中,男女之间均无明显差异。然而,在特定症状的意识和归因方面存在统计学上的显著差异。女性表现出对思维障碍和寡言的较差意识,以及对冷漠的更高错误归因。较高的认知和阳性症状、疾病的早期阶段以及已婚状态解释了女性洞察力维度的缺陷。在男性中,其他变量,如功能较低、年龄较大、其他精神病诊断,以及在较低程度上认知、阳性和兴奋症状的评分较高,解释了洞察力维度的缺陷。这些数据可以帮助设计针对特定性别的预防和治疗策略。

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