Vrbova Kristyna, Prasko Jan, Ociskova Marie, Holubova Michaela
Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic.
Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic.
Neuropsychiatr Dis Treat. 2017 Aug 3;13:2073-2083. doi: 10.2147/NDT.S141749. eCollection 2017.
The purpose of the study was to explore whether the comorbidity of social phobia affects symptoms severity, positive and negative symptoms, self-stigma, hope, and quality of life in patients with schizophrenia spectrum disorders.
This is a cross-sectional study in which all participants completed the Internalized Stigma of Mental Illness (ISMI) scale, Adult Dispositional Hope Scale (ADHS), Liebowitz Social Anxiety Scale (LSAS), Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Positive and Negative Syndrome Scale (PANSS), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Temperament and Character Inventory - Revised (TCI-R), and the demographic questionnaire. The disorder severity was assessed both by a psychiatrist (Clinical Global Impression Severity - the objective version [objCGI-S] scale) and by the patients (Clinical Global Impression Severity - the subjective version [subjCGI-S] scale). The patients were in a stabilized state that did not require changes in the treatment. Diagnosis of schizophrenia, schizoaffective disorder, or delusional disorder was determined according to the International Classification of Diseases 10th Revision (ICD-10) research criteria. A structured interview by Mini International Neuropsychiatric Interview was used to confirm the diagnosis.
The study included 61 patients of both genders. Clinically, the patients with comorbid social phobia had the earlier onset of the illness, more severe current psychopathology, more intense anxiety (general and social), and higher severity of depressive symptoms. The patients with comorbid social phobia showed the significantly lower quality of life compared to the patients without this comorbidity. The patients with comorbid social phobia also had a statistically lower mean level of hope and experienced a higher rate of the self-stigma. They also exhibited higher average scores of personality trait harm avoidance (HA) and a lower score of personality trait self-directedness (SD).
The study demonstrated differences in demographic factors, the severity of the disorder, self-stigma, hope, HA, and SD between patients with schizophrenia spectrum disorders with and without comorbid social phobia.
本研究旨在探讨社交恐惧症合并症是否会影响精神分裂症谱系障碍患者的症状严重程度、阳性和阴性症状、自我污名化、希望及生活质量。
这是一项横断面研究，所有参与者均完成了精神疾病内化污名量表（ISMI）、成人气质性希望量表（ADHS）、莱博维茨社交焦虑量表（LSAS）、贝克焦虑量表（BAI）、贝克抑郁量表第二版（BDI-II）、阳性与阴性症状量表（PANSS）、生活质量享受与满意度问卷（Q-LES-Q）、修订版气质与性格问卷（TCI-R）以及人口统计学调查问卷。疾病严重程度由精神科医生（临床总体印象严重程度——客观版[objCGI-S]量表）和患者（临床总体印象严重程度——主观版[subjCGI-S]量表）进行评估。患者处于稳定状态，无需调整治疗方案。精神分裂症、精神分裂情感性障碍或妄想性障碍的诊断依据国际疾病分类第10版（ICD-10）研究标准确定。采用迷你国际神经精神访谈进行结构化访谈以确诊。
该研究纳入了61名男女患者。临床上，合并社交恐惧症的患者发病更早，当前精神病理学症状更严重，焦虑（一般和社交方面）更强烈，抑郁症状严重程度更高。与无此合并症的患者相比，合并社交恐惧症的患者生活质量显著更低。合并社交恐惧症的患者希望的平均水平在统计学上也更低，且自我污名化发生率更高。他们还表现出人格特质回避伤害（HA）的平均得分更高，而人格特质自我导向（SD）的得分更低。
该研究表明，有和没有合并社交恐惧症的精神分裂症谱系障碍患者在人口统计学因素、疾病严重程度、自我污名化、希望、回避伤害和自我导向方面存在差异。
