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心理病理维度与临床医生的主观体验。

Psychopathological dimensions and the clinician's subjective experience.

机构信息

Centre of Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy.

Department of Neurology and Psychiatry, Sapienza University of Rome, Italy.

出版信息

Psychiatry Res. 2017 Dec;258:407-414. doi: 10.1016/j.psychres.2017.08.079. Epub 2017 Aug 30.

Abstract

Classical psychopathology highly valued the interaction between clinician and patient, and recent findings have provided preliminary evidence of an association between categorical psychiatric diagnosis and the clinician's subjective experience during the first clinical assessment. To extend these findings, the present study examined the relationship between psychopathological dimensions and clinicians' subjective experiences. The study involved 45 clinicians and 783 patients in several psychiatric inpatient and outpatient units. When they saw a new patient, the clinicians completed the Assessment of Clinician's Subjective Experience questionnaire (ACSE) and the 24-item Brief Psychiatric Rating Scale (BPRS). Scores on five core psychopathological dimensions supported by meta-analytic evidence (Affect, Positive Symptoms, Negative Symptoms, Activation, Disorganization) were derived from the BPRS. Multivariate analysis revealed that each psychopathological dimension was characterized by a distinct pattern of independent associations with certain aspects of Clinician's Subjective Experience, as measured by the ACSE. This study provided preliminary evidence of significant and theoretically consistent relationships between major psychopathological dimensions and the psychiatrist's subjective experience during the first clinical evaluation. Improving the understanding of intersubjective processes may have important implications for theory, practice, research, and training.

摘要

经典精神病理学非常重视临床医生和患者之间的互动,最近的研究结果为精神科诊断的类别与临床医生在首次临床评估期间的主观体验之间的关联提供了初步证据。为了扩展这些发现,本研究探讨了精神病理学维度与临床医生主观体验之间的关系。该研究涉及几个精神病住院和门诊单位的 45 名临床医生和 783 名患者。当他们看到新患者时,临床医生完成了临床医生主观体验评估问卷(ACSE)和 24 项简明精神病评定量表(BPRS)。从 BPRS 中得出了五个得到荟萃分析证据支持的核心精神病理学维度的评分(情感、阳性症状、阴性症状、激活、紊乱)。多变量分析表明,每个精神病理学维度都以与 ACSE 测量的某些方面的独特模式相关联的特定方面的主观体验为特征。这项研究为主要精神病理学维度与精神病医生在首次临床评估期间的主观体验之间存在显著且理论上一致的关系提供了初步证据。增进对主体间过程的理解可能对理论、实践、研究和培训具有重要意义。

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