Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
Soc Psychiatry Psychiatr Epidemiol. 2022 Jul;57(7):1305-1318. doi: 10.1007/s00127-022-02220-2. Epub 2022 Feb 13.
Fears of relapse in people diagnosed with schizophrenia have long been recognised as an impediment to recovery and wellbeing. However, the extent of the empirical basis for the fear of relapse concept is unclear. A systematic review is required to collate available evidence and define future research directions.
A pre-registered systematic search (PROSPERO CRD42020196964) of four databases (PubMED, MEDLINE-Ovid, PsycINFO-Ovid, and Cochrane Central Register of Controlled Trials) was conducted from their inception to 05/04/2021.
We found nine eligible studies. Five were quantitative (4 descriptive and 1 randomised controlled trial), and four were qualitative. The available quantitative evidence suggests that fear of relapse may have concurrent positive relationships with depression (r = 0.72) and suicide ideation (r = 0.48), and negative relationship with self-esteem (r = 0.67). Qualitative synthesis suggests that fear of relapse is a complex phenomenon with behavioural and emotional components which has both direct and indirect effects on wellbeing.
Evidence in this area is limited and research with explicit service user and carer involvement is urgently needed to develop new and/or refine existing measurement tools, and to measure wellbeing rather than psychopathology. Nonetheless, clinicians should be aware that fear of relapse exists and appears to be positively associated with depression and suicide ideation, and negatively associated with self-esteem. Fear of relapse can include fears of losing personal autonomy and/or social/occupational functioning. It appears to impact carers as well as those diagnosed with schizophrenia.
长期以来，人们一直担心精神分裂症患者会复发，这被认为是康复和幸福的障碍。然而，恐惧复发这一概念的实证基础的程度尚不清楚。需要进行系统审查，以整理现有证据并确定未来的研究方向。
从四个数据库（PubMed、MEDLINE-Ovid、PsycINFO-Ovid 和 Cochrane 对照试验中心注册）的创建开始，对预注册的系统搜索（PROSPERO CRD42020196964）进行了检索，检索时间截至 2021 年 4 月 5 日。
我们发现了 9 项符合条件的研究。其中 5 项为定量研究（4 项描述性研究和 1 项随机对照试验），4 项为定性研究。现有的定量证据表明，恐惧复发可能与抑郁（r=0.72）和自杀意念（r=0.48）存在直接的正相关关系，与自尊（r=0.67）呈负相关关系。定性综合分析表明，恐惧复发是一种复杂的现象，具有行为和情感成分，对幸福感既有直接影响，也有间接影响。
该领域的证据有限，迫切需要具有明确服务使用者和照顾者参与的研究，以开发新的和/或改进现有的测量工具，并测量幸福感，而不是精神病理学。尽管如此，临床医生应该意识到恐惧复发的存在，并且似乎与抑郁和自杀意念呈正相关，与自尊呈负相关。恐惧复发可能包括对失去个人自主权和/或社会/职业功能的恐惧。它似乎不仅对精神分裂症患者有影响，也对照顾者有影响。
