Singla Neha, Avasthi Ajit, Grover Sandeep
Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Asian J Psychiatr. 2020 Aug;52:102162. doi: 10.1016/j.ajp.2020.102162. Epub 2020 May 15.
Little information is available from India, on psychological recovery in patients with schizophrenia. Accordingly, this study aimed to evaluate the correlates and stages of the psychological recovery of patients with schizophrenia. 100 patients, in clinical remission, were evaluated on Stages of Recovery Instrument (STORI), Functional Social Support Questionnaire, WHO Quality of life-BREF, Ways of Coping Checklist, Internalised Stigma of Mental Illness Scale, Scale to Assess Unawareness of Mental Disorder and Knowledge of mental illness scale. Majority of the patients (N = 50) belonged to the stage-5 (Growth), and this was followed by those in the stage-4 (stage of rebuilding; N = 22) and stage-3 (stage of preparation; N = 16) of recovery. A higher stage of recovery was associated with lower stigma in all the domains except stigma resistance. Higher use of confrontative coping and accepting responsibility was associated with a higher score in the awareness stage of recovery. In terms of insight, higher awareness about the effect of medication was associated with a higher stage of recovery. Higher disability in the domain of self-care was seen in the lower stage of recovery. Better quality of life in the physical health domain was associated with being in a higher stage of recovery. To conclude, findings of the present study suggest that stigma plays a significant role in determining the outcome in the form of personal recovery. These findings suggest that to organize the services to promote personal recovery, clinicians should not only aim at symptom amelioration but also must focus on stigma to promote psychological recovery.
在印度，关于精神分裂症患者心理康复的信息很少。因此，本研究旨在评估精神分裂症患者心理康复的相关因素和阶段。对100名临床缓解期的患者进行了康复阶段量表（STORI）、功能性社会支持问卷、世界卫生组织生活质量简表、应对方式清单、精神疾病内化耻辱感量表、精神障碍自知力评估量表和精神疾病知识量表的评估。大多数患者（N = 50）处于康复的第5阶段（成长阶段），其次是处于第4阶段（重建阶段；N = 22）和第3阶段（准备阶段；N = 16）的患者。除了耻辱抵抗外，在所有领域中，康复阶段越高，耻辱感越低。在康复的认知阶段，更多地使用对抗性应对方式和承担责任与更高的得分相关。就洞察力而言，对药物效果的更高认知与更高的康复阶段相关。在康复的较低阶段，自我护理领域的残疾程度更高。身体健康领域更好地生活质量与更高的康复阶段相关。总之，本研究结果表明，耻辱感在以个人康复形式决定结果方面起着重要作用。这些发现表明，为了组织促进个人康复的服务，临床医生不仅应旨在改善症状，还必须关注耻辱感以促进心理康复。
