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儿童时期创伤、抑郁、睡眠质量与精神分裂症患者的精神病症状和自杀意念及其相关性。

Childhood trauma, depression, and sleep quality and their association with psychotic symptoms and suicidality in schizophrenia.

机构信息

Izmir Katip Celebi University, Atatürk Education and Training Hospital, Psychiatry Department, Izmir, Turkey.

University of Health Sciences, Izmir Tepecik Education and Training Hospital, Psychiatry Department, Izmir, Turkey.

出版信息

Psychiatry Res. 2017 Dec;258:557-564. doi: 10.1016/j.psychres.2017.08.081. Epub 2017 Sep 7.

Abstract

This study involved the examination of the relationship between childhood trauma and both psychotic symptoms and suicidality in patients with schizophrenia after controlling for the possible confounding factors, such as clinical features, depression, and sleep quality. The Childhood Trauma Questionnaire-Short Form, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Pittsburgh Sleep Quality Index (PSQI), and the suicidality subscale of Mini-International Neuropsychiatric Interview (MINI) were administered to 199 patients with schizophrenia. We used sequential multiple stepwise regression analyses in which positive symptoms, negative symptoms, overall psychopathology, total symptoms of schizophrenia, and suicidality were dependent variables. Depressive symptomatology and childhood physical abuse significantly contributed to positive, negative, general psychopathology, and global schizophrenia symptomatology. Interestingly, general psychopathology scores were negatively associated with childhood physical neglect. Also, subjective sleep quality significantly contributed to positive schizophrenia symptoms. Although prior suicide attempts and depression were significant antecedents of suicidal ideation, no association between suicidality and both childhood trauma and sleep was found. Childhood physical abuse could have an impact on psychopathology in schizophrenia. In addition to childhood trauma, depression, sleep disturbances, and clinical features should be considered and inquired about in the course of clinical care of schizophrenia patients.

摘要

本研究旨在探讨童年创伤与精神分裂症患者精神病症状和自杀意念之间的关系,在控制了可能的混杂因素(如临床特征、抑郁和睡眠质量)后。采用儿童创伤问卷简表、阳性与阴性症状量表(PANSS)、精神分裂症的卡尔加里抑郁量表(CDSS)、匹兹堡睡眠质量指数(PSQI)和迷你国际神经精神访谈(MINI)自杀意念分量表对 199 例精神分裂症患者进行评估。我们采用逐步多元回归分析,将阳性症状、阴性症状、总体精神病学、总体精神分裂症症状和自杀意念作为因变量。抑郁症状和童年期躯体虐待对阳性、阴性、一般精神病学和总体精神分裂症症状有显著影响。有趣的是,一般精神病学评分与童年期躯体忽视呈负相关。此外,主观睡眠质量对阳性精神分裂症症状有显著影响。尽管既往自杀企图和抑郁是自杀意念的重要前驱因素,但未发现自杀意念与童年创伤和睡眠之间存在关联。童年期躯体虐待可能对精神分裂症的精神病学有影响。除了童年创伤外,还应考虑抑郁、睡眠障碍和临床特征,并在精神分裂症患者的临床护理过程中进行询问。

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