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首发精神病中的听觉和非听觉幻觉:与多种临床特征的差异关联。

Auditory and non-auditory hallucinations in first-episode psychosis: Differential associations with diverse clinical features.

作者信息

Galletti Chiara, Paolini Enrico, Tortorella Alfonso, Compton Michael T

机构信息

Department of Medicine, Section of Psychiatry, University of Perugia, Perugia, PG, Italy.

Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA.

出版信息

Psychiatry Res. 2017 Aug;254:268-274. doi: 10.1016/j.psychres.2017.04.056. Epub 2017 Apr 24.

Abstract

Data from 247 first-episode psychosis patients were used to explore associations between types of hallucinations and nine diverse clinical characteristics. Psychopathology was rated using the Scale for the Assessment of Positive Symptoms and Scale for the Assessment of Negative Symptoms (SANS). Childhood adversity was assessed with seven instruments; family history with an adapted version of the Family Interview for Genetic Studies; age at onset of psychosis and duration of untreated psychosis (DUP) with the Symptom Onset in Schizophrenia inventory; and insight with the Birchwood Insight Scale. Both principal component analysis-derived Auditory and Non-Auditory Hallucinations were similarly associated with delusions of influence, negative affect delusions (jealousy and sin/guilt), interpersonal childhood abuse, DUP, and insight. However, the two hallucination domains had different associations with grandiose/religious, paranoid, and somatic delusions; SANS score; childhood violence exposure; cannabis use disorders; and cocaine/other drug use disorders. Neither Auditory nor Non-Auditory Hallucinations were associated with childhood neglect, age at onset, alcohol use disorders, family history, or mode of onset of psychosis. Findings support considering hallucinations not as a unitary psychopathological construct. They represent at least two domains and are correlated in different ways with diverse clinical variables.

摘要

来自247名首发精神病患者的数据被用于探究幻觉类型与九种不同临床特征之间的关联。使用阳性症状评定量表和阴性症状评定量表(SANS)对精神病理学进行评分。采用七种工具评估童年逆境;使用遗传研究家族访谈的改编版评估家族史;使用精神分裂症症状发作量表评估精神病发作年龄和未治疗精神病持续时间(DUP);使用伯奇伍德洞察力量表评估洞察力。主成分分析得出的听觉幻觉和非听觉幻觉均与被控制妄想、消极情感妄想(嫉妒和罪恶/内疚)、童年人际虐待、DUP和洞察力存在相似关联。然而,这两个幻觉领域与夸大/宗教、偏执和躯体妄想;SANS评分;童年暴力暴露;大麻使用障碍;以及可卡因/其他药物使用障碍存在不同关联。听觉幻觉和非听觉幻觉均与童年忽视、发病年龄、酒精使用障碍、家族史或精神病发作方式无关。研究结果支持不将幻觉视为单一的精神病理学结构。它们至少代表两个领域,并且与不同的临床变量以不同方式相关。

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