Okada Hiroki, Hirano Dsisuke, Taniguchi Takamichi
Department of Occupational Therapy, Medical Corporation Nasukougen Hospital, Nasu, Tochigi, Japan.
Department of Occupational Therapy, School of Health Science, International University of Health and Welfare, Ōtawara, Tochigi, Japan.
Schizophr Res Treatment. 2021 Feb 20;2021:8864352. doi: 10.1155/2021/8864352. eCollection 2021.
Negative symptoms of schizophrenia have generally been defined using five factors; however, few studies have examined the relationship between these five factors and functional outcomes. In addition, there is no definitive conclusion regarding the association between negative symptoms and various aspects of functional outcomes (daily living, social, and vocational). This study is aimed at examining the relationship between these five domains of negative symptoms and different functional outcomes. Patients diagnosed with chronic schizophrenia ( = 100) were selected for the evaluation. We used the Brief Negative Symptom Scale to assess negative symptoms, the Brief Psychiatric Rating Scale to assess positive symptoms, the Schizophrenia Cognition Rating Scale to assess cognition, and the Evaluative Beliefs Scale (negative self-assessment) to assess psychological factors. We analyzed their relative impact on Social Functioning Scale domains using hierarchical multiple regression analysis. Concerning the relationship between daily living and negative symptoms, cognitive function showed the highest association with residential outcomes, such as self-care and shopping, while avolition appeared to show an additional contribution; however, for recreational outcomes, avolition showed the main association, whereas cognitive function showed no additional contribution. For social outcomes, asociality and negative self-assessment showed the main associations, while vocational outcomes were determined by both cognitive function and multiple negative symptoms, such as avolition, anhedonia, asociality, and alogia. Since negative symptom domains appear to differentially impact each outcome, specifically daily living outcome, it is important to evaluate the residential outcomes and recreational outcomes separately. Overall, the present study points to the importance of formulating psychosocial treatment strategies specific for each type of preferred outcome in patients with schizophrenia.
精神分裂症的阴性症状通常用五个因素来定义；然而，很少有研究考察这五个因素与功能结局之间的关系。此外，关于阴性症状与功能结局的各个方面（日常生活、社交和职业）之间的关联尚无定论。本研究旨在考察阴性症状的这五个领域与不同功能结局之间的关系。选取了100例被诊断为慢性精神分裂症的患者进行评估。我们使用简明阴性症状量表评估阴性症状，简明精神病评定量表评估阳性症状，精神分裂症认知评定量表评估认知，以及评价信念量表（消极自我评估）评估心理因素。我们使用分层多元回归分析来分析它们对社会功能量表各领域的相对影响。关于日常生活与阴性症状之间的关系，认知功能与居住结局（如自我照料和购物）的关联最为密切，而意志缺乏似乎有额外的影响；然而，对于娱乐结局，意志缺乏显示出主要关联，而认知功能没有额外影响。对于社交结局，社交退缩和消极自我评估显示出主要关联，而职业结局则由认知功能和多种阴性症状（如意志缺乏、快感缺失、社交退缩和言语贫乏）共同决定。由于阴性症状领域似乎对每种结局有不同影响，特别是日常生活结局，因此分别评估居住结局和娱乐结局很重要。总体而言，本研究指出了为精神分裂症患者制定针对每种偏好结局类型的心理社会治疗策略的重要性。
