Baethge Christopher, Jänner Michaela, Gaebel Wolfgang, Malevani Jaroslav
Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Eur Arch Psychiatry Clin Neurosci. 2017 Jun;267(4):295-301. doi: 10.1007/s00406-016-0738-x. Epub 2016 Oct 17.
Hallucinations are at the core of the diagnosis of schizophrenia and schizoaffective disorders, and many neuroscience studies focus on hallucinations. However, there is a lack of data on prevalence, subtyping, and clinical correlates of hallucinations as well as on the comparison of hallucinating schizophrenia versus hallucinating schizoaffective patients. Analysis of all psychopathology evaluations is based on the AMDP scale in a German psychiatric university hospital between 2007 and 2013 regarding patients with schizophrenia or schizoaffective disorder (diagnosed according to ICD-10). Hallucinating versus non-hallucinating patients and age- and gender-matched hallucinating schizophrenic versus schizoaffective patients were compared with regard to key psychopathological and demographic characteristics. Relative to patients with schizoaffective disorder, patients with schizophrenia more often hallucinated at admission (36.6 vs. 16.2 %, RR: 2.3, p < 0.001). By subtype, frequency of hallucinations ranked auditory verbal > other auditory > visual > somatic/tactile > olfactory/gustatory. Hallucinating patients of either disorder were more often affected with respect to delusions (83 vs. 62 % and 81 vs. 48 % among patients with schizophrenia and schizoaffective disorder, respectively [both p < 0.0001]) and anxiety. Hallucinating patients with schizoaffective disorder did not differ from hallucinating patients with schizophrenia. This is one of the few studies providing data on hallucinations in a routine clinical care setting. Hallucinations are a sign and likely a cause of greater illness severity. Patients with schizoaffective disorder less often experience hallucinations than patients with schizophrenia, but if they do, they seem to resemble patients with schizophrenia with regard to illness severity.
幻觉是精神分裂症和分裂情感性障碍诊断的核心,许多神经科学研究都聚焦于幻觉。然而,关于幻觉的患病率、亚型、临床相关因素,以及幻觉型精神分裂症患者与幻觉型分裂情感性障碍患者的比较,目前缺乏相关数据。对一所德国精神病学大学医院2007年至2013年间所有精神病理学评估进行分析,这些评估基于AMDP量表,涉及精神分裂症或分裂情感性障碍患者(根据ICD - 10诊断)。就关键精神病理学和人口统计学特征,对有幻觉与无幻觉患者,以及年龄和性别匹配的幻觉型精神分裂症患者与幻觉型分裂情感性障碍患者进行了比较。相对于分裂情感性障碍患者,精神分裂症患者在入院时出现幻觉的频率更高(36.6%对16.2%,相对危险度:2.3,p < 0.001)。按亚型划分,幻觉出现频率依次为言语性幻听 > 其他幻听 > 幻视 > 躯体/触觉幻觉 > 嗅觉/味觉幻觉。两种障碍的幻觉患者在妄想方面受影响的比例更高(精神分裂症患者和分裂情感性障碍患者中分别为83%对62%以及81%对48% [p均< 0.0001]),且在焦虑方面也是如此。幻觉型分裂情感性障碍患者与幻觉型精神分裂症患者并无差异。这是少数在常规临床护理环境中提供幻觉相关数据的研究之一。幻觉是病情更严重的一个迹象,且可能是病因。分裂情感性障碍患者出现幻觉的频率低于精神分裂症患者,但如果出现幻觉,在病情严重程度方面似乎与精神分裂症患者相似。