Ogawa Yasuhiro, Fukuhara Keita, Tanaka Hiroyuki, Nagata Yuma, Ishimaru Daiki, Nishikawa Takashi
Department of Clinical Rehabilitation, Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino City.
Department of Rehabilitation, Hokutokai Sawa Hospital, Osaka, Japan.
J Nerv Ment Dis. 2019 Oct;207(10):815-819. doi: 10.1097/NMD.0000000000001038.
Although the psychological denial model argues that poor insight is a result of defense mechanisms, the direct relationship between the two remains unclear. This study aimed to examine the relationship between insight into illness and defense mechanisms while considering cognitive dysfunction in schizophrenia. A total of 38 patients with schizophrenia were evaluated for level of insight (Schedule for the Assessment of Insight), defense mechanisms (Defense Style Questionnaire), neurocognitive function (Brief Assessment of Cognition in Schizophrenia), and psychotic symptoms (Brief Psychiatric Rating Scale). Regarding level of insight, partial correlation analysis controlling neurocognitive and psychotic variables showed that "recognition of illness" was positively correlated with immature defense styles and negatively correlated with mature defense styles. Stepwise regression analyses revealed that "recognition of illness" was significantly predicted by immature defense styles. Our findings suggest that patients who tend to use immature defense styles are more likely to accept their own mental illness.
尽管心理否认模型认为洞察力差是防御机制的结果，但二者之间的直接关系仍不明确。本研究旨在探讨精神分裂症患者的疾病洞察力与防御机制之间的关系，同时考虑认知功能障碍。共有38例精神分裂症患者接受了洞察力水平（洞察力评估量表）、防御机制（防御方式问卷）、神经认知功能（精神分裂症认知简要评估）和精神症状（简明精神病评定量表）的评估。关于洞察力水平，控制神经认知和精神症状变量的偏相关分析表明，“对疾病的认识”与不成熟防御方式呈正相关，与成熟防御方式呈负相关。逐步回归分析显示，不成熟防御方式能显著预测“对疾病的认识”。我们的研究结果表明，倾向于使用不成熟防御方式的患者更有可能接受自己的精神疾病。
