Holubova Michaela, Prasko Jan, Ociskova Marie, Kantor Kryštof, Vanek Jakub, Slepecky Milos, Vrbova Kristyna
Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic,
Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic,
Psychol Res Behav Manag. 2019 Feb 1;12:81-95. doi: 10.2147/PRBM.S179838. eCollection 2019.
Modern psychiatry focuses on self-stigma, coping strategies, and quality of life (QoL). This study looked at relationships among severity of symptoms, self-stigma, demographics, coping strategies, and QoL in patients with neurotic spectrum disorders.
A total of 153 clinically stable participants who met criteria for generalized anxiety disorder, social phobia, panic disorder, agoraphobia, mixed anxiety-depressive disorder, adjustment disorders, somatoform disorders, or obsessive-compulsive disorder were included in a cross-sectional study. Psychiatrists examined patients during regular psychiatric checkups. Patients completed the Quality of Life Satisfaction and Enjoyment Questionnaire (Q-LES-Q), Internalized Stigma of Mental Illness Scale (ISMI), a sociodemographic questionnaire, the Stress Coping Style Questionnaire (Strategie Zvládání Stresu [SVF] 78), and the Clinical Global Impression (CGI) scale.
The diagnostic subgroups differed significantly in age and use of negative coping strategies, but not in other measured clinical or psychological variables. The findings showed that neither sex nor partnership played a role in perceived QoL. All Q-LES-Q domains correlated negatively with all ISMI domains, except school/study. Unemployed and employed groups of patients differed in QoL. Each of the coping strategies, except the need for social support, was related to self-stigma. The findings showed that sex, partnership, education, and employment played no role in self-stigma. No differences between sexes in positive coping strategies, severity of disorder, self-stigma, or QoL were found. QoL correlated significantly with all coping strategies, except for guilt denial. Multiple regression showed the most important factors to be positive coping, employment, and overall self-stigma rating, explaining 32.9% of QoL. Mediation analysis showed self-stigma level and negative coping strategies to be the most influential. The most substantial factors associated with self-stigma, as indicated by regression analysis, were Q-LES-Q total, subjective CGI, and positive coping strategies, which clarified 44.5% of the ISMI.
The study confirmed associations among self-stigma, quality of life, disorder severity, and coping strategies of outpatients with neurotic spectrum disorders.
现代精神病学关注自我污名、应对策略和生活质量（QoL）。本研究探讨了神经症谱系障碍患者症状严重程度、自我污名、人口统计学特征、应对策略和生活质量之间的关系。
一项横断面研究纳入了153名临床症状稳定的参与者，这些参与者符合广泛性焦虑障碍、社交恐惧症、惊恐障碍、广场恐惧症、混合性焦虑抑郁障碍、适应障碍、躯体形式障碍或强迫症的诊断标准。精神科医生在定期的精神科检查中对患者进行检查。患者完成了生活质量满意度和享受问卷（Q-LES-Q）、精神疾病内化污名量表（ISMI）、一份社会人口学问卷、压力应对方式问卷（Strategie Zvládání Stresu [SVF] 78）和临床总体印象（CGI）量表。
各诊断亚组在年龄和消极应对策略的使用上存在显著差异，但在其他测量的临床或心理变量上无差异。研究结果表明，性别和伴侣关系对感知到的生活质量均无影响。除学校/学习领域外，Q-LES-Q的所有领域均与ISMI的所有领域呈负相关。失业患者组和就业患者组在生活质量上存在差异。除了对社会支持的需求外，每种应对策略都与自我污名有关。研究结果表明，性别、伴侣关系、教育程度和就业情况对自我污名均无影响。在积极应对策略、疾病严重程度、自我污名或生活质量方面未发现性别差异。生活质量与除内疚否认外的所有应对策略均显著相关。多元回归分析显示，最重要的因素是积极应对、就业和总体自我污名评分，它们解释了生活质量变异的32.9%。中介分析表明，自我污名水平和消极应对策略的影响最大。回归分析显示，与自我污名相关的最重要因素是Q-LES-Q总分、主观CGI评分和积极应对策略，它们解释了ISMI变异的44.5%。
该研究证实神经症谱系障碍门诊患者的自我污名、生活质量、疾病严重程度和应对策略之间存在关联。
