Poloni Nicola, Zizolfi Daniele, Ielmini Marta, Pagani Roberto, Caselli Ivano, Diurni Marcello, Milano Anna, Callegari Camilla
Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy.
Psychol Res Behav Manag. 2018 Apr 10;11:123-131. doi: 10.2147/PRBM.S159571. eCollection 2018.
Resilience is a multidimensional process of adaptation aimed to overcome stressful or traumatic life experiences; only in the last few years it has been considered as a personal resource in psychosis and schizophrenia. This study aimed to assess the relationship between intrapersonal and interpersonal resilience factors and schizophrenia, particularly whether and how resilience can improve the course of psychotic illness.
In this observational study, all patients recruited had to fulfill the following inclusion criteria: diagnosis of schizophrenia spectrum disorder (); aged between 18 and 65 years; provided written informed consent; to be clinically stable (Clinical Global Impression Scale <3); history of illness ≥5 years; to be compliant with antipsychotic therapy over the last year; and regular submission to periodic monthly psychiatric visits. Patients were evaluated through the following scales: Resilience Scale for Adults (RSA) for resilience; Brief Psychiatric Rating Scale-Anchored version (BPRS-A), Scale for the Assessment of Negative Symptoms (SANS), and Scale for the Assessment of Positive Symptoms (SAPS) for psychotic symptomatology; and Life Skills Profile (LSP) for psychosocial functioning. Statistical analysis was performed by SPSS. Partial correlations were evaluated to assess the relationship between RSA total scores and subscores and BPRS-A, SANS, SAPS, and LSP total scores, removing the common variance among variables. Then, a series of hierarchical multiple linear regression models were used to examine the association between resilience, psychopathology, and psychosocial functioning.
A statistically significant negative correlation among intrapersonal resilience factors and BPRS-A total score emerged, predicting psychiatric symptoms severity and explaining approximately 31% of the BPRS-A variance; otherwise, only the interpersonal resilience factors associated with social support were statistically and positively correlated with LSP total score, predicting psychosocial functioning and explaining the 11% of LSP variance.
The specific contribution that resilience factors may have in predicting the severity of symptoms and the extent of psychosocial functioning emphasizes the importance of personalizing treatment for patients affected by schizophrenia, promoting personal resources, and translating them into better outcomes.
心理韧性是一个旨在克服压力或创伤性生活经历的多维度适应过程；直到最近几年，它才被视为精神病和精神分裂症中的一种个人资源。本研究旨在评估人际和个体内部心理韧性因素与精神分裂症之间的关系，特别是心理韧性是否以及如何能够改善精神病性疾病的病程。
在这项观察性研究中，所有招募的患者必须满足以下纳入标准：精神分裂症谱系障碍诊断（）；年龄在18至65岁之间；提供书面知情同意书；临床稳定（临床总体印象量表<3）；病程≥5年；在过去一年中依从抗精神病治疗；并且定期每月接受精神科复诊。通过以下量表对患者进行评估：用于评估心理韧性的成人心理韧性量表（RSA）；用于评估精神病性症状的简明精神病评定量表锚定版（BPRS-A）、阴性症状评定量表（SANS）和阳性症状评定量表（SAPS）；以及用于评估社会心理功能的生活技能概况（LSP）。采用SPSS进行统计分析。评估偏相关性以评估RSA总分及子分数与BPRS-A、SANS、SAPS和LSP总分之间的关系，消除变量间的共同方差。然后，使用一系列分层多元线性回归模型来检验心理韧性、精神病理学和社会心理功能之间的关联。
个体内部心理韧性因素与BPRS-A总分之间出现了具有统计学意义的负相关，可预测精神症状严重程度并解释约31%的BPRS-A方差；否则，仅与社会支持相关的人际心理韧性因素与LSP总分存在统计学上的正相关，可预测社会心理功能并解释11%的LSP方差。
心理韧性因素在预测症状严重程度和社会心理功能程度方面可能具有的特定作用，强调了对精神分裂症患者进行个性化治疗、促进个人资源并将其转化为更好治疗效果的重要性。
