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精神病理学与精神分裂谱系障碍患者并发功能水平和主观幸福感的关系。

The association of psychopathology with concurrent level of functioning and subjective well-being in persons with schizophrenia spectrum disorders.

机构信息

Universitäre Psychiatrische Kliniken Basel, Universität Basel, Wilhelm Klein-Str. 27, 4012, Basel, Switzerland.

Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2018 Aug;268(5):455-459. doi: 10.1007/s00406-017-0780-3. Epub 2017 Mar 29.

Abstract

The objective is to investigate the relationship between psychopathology measured by the positive and negative syndrome scale (PANSS) and concurrent global assessment of functioning (GAF) and subjective well-being under neuroleptics (SWN) in patients with schizophrenia spectrum disorder (SSD) regarding severity of illness and disease phase. We analyzed a sample of 202 SSD patients consisting of first episode psychosis (FEP) and multiple episode psychosis (MEP) patients followed up to 12 months using linear mixed models. All PANSS syndromes except excitement were associated with GAF scores (positive syndrome: p < 0.001, d = 1.21; negative syndrome: p = 0.029, d = 0.015; disorganized syndrome: p < 0.001, d = 0.37; anxiety/depression syndrome: p < 0.001, d = 0.49), and positive symptoms had an increasing impact on global functioning with higher severity of illness (mildly ill: p = 0.039, d = 0.22; moderately ill: p < 0.001, d = 0.28; severely ill: p < 0.001, d = 0.69). SWN was associated with positive (p = 0.002, d = 0.22) and anxiety/depression (p < 0.001, d = 0.38) syndromes. Subgroup analyses showed differing patterns depending on illness severity and phase. Over all our results show different patterns of associations of psychopathology and concurrent functioning and subjective well-being. These findings contribute knowledge on the possible role of specific psychopathological syndromes for the functioning and well-being of our patients and may enable tailored treatments depending on severity and phase of illness.

摘要

目的是研究精神分裂症谱系障碍(SSD)患者的精神病症状(通过阳性和阴性症状量表(PANSS)测量)与同时的功能全面评估(GAF)和抗精神病药物治疗下的主观幸福感(SWN)之间的关系,以及疾病严重程度和疾病阶段的影响。我们使用线性混合模型分析了一个由 202 名 SSD 患者组成的样本,其中包括首发精神病(FEP)和多次发作精神病(MEP)患者,随访时间为 12 个月。除兴奋外,所有 PANSS 综合征都与 GAF 评分相关(阳性综合征:p < 0.001,d = 1.21;阴性综合征:p = 0.029,d = 0.015;紊乱综合征:p < 0.001,d = 0.37;焦虑/抑郁综合征:p < 0.001,d = 0.49),阳性症状对全球功能的影响随着疾病严重程度的增加而增加(轻度:p = 0.039,d = 0.22;中度:p < 0.001,d = 0.28;重度:p < 0.001,d = 0.69)。SWN 与阳性(p = 0.002,d = 0.22)和焦虑/抑郁(p < 0.001,d = 0.38)综合征相关。亚组分析显示,根据疾病严重程度和阶段,存在不同的模式。总之,我们的研究结果显示了精神病症状和同时的功能和主观幸福感之间不同的关联模式。这些发现为特定的精神病症状与患者的功能和幸福感之间的可能关系提供了知识,并可能根据疾病的严重程度和阶段进行个体化治疗。

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