Department of Psychiatry, University of Oxford, Oxford, UK.
Oxford Health NHS Foundation Trust, Oxford, UK.
Psychol Med. 2023 Jul;53(9):4121-4129. doi: 10.1017/S0033291722000800. Epub 2022 Apr 7.
Persecutory fears build on feelings of vulnerability that arise from negative views of the self. Body image concerns have the potential to be a powerful driver of feelings of vulnerability. Body image concerns are likely raised in patients with psychosis given the frequent weight gain. We examined for the first-time body esteem - the self-evaluation of appearance - in relation to symptom and psychological correlates in patients with current persecutory delusions.
One-hundred and fifteen patients with persecutory delusions in the context of non-affective psychosis completed assessments of body image, self-esteem, body mass index (BMI), psychiatric symptoms and well-being. Body esteem was also assessed in 200 individuals from the general population.
Levels of body esteem were much lower in patients with psychosis than non-clinical controls ( = 1.2, < 0.001). In patients, body esteem was lower in women than men, and in the overweight or obese BMI categories than the normal weight range. Body image concerns were associated with higher levels of depression ( = 0.55, < 0.001), negative self-beliefs ( -0.52, < 0.001), paranoia ( -0.25, = 0.006) and hallucinations ( -0.21, = 0.025). Body image concerns were associated with lower levels of psychological wellbeing ( 0.41, < 0.001), positive self-beliefs ( 0.40, < 0.001), quality of life ( 0.23, = 0.015) and overall health ( 0.31, = 0.001).
Patients with current persecutory delusions have low body esteem. Body image concerns are associated with poorer physical and mental health, including more severe psychotic experiences. Improving body image for patients with psychosis is a plausible target of intervention, with the potential to result in a wide range of benefits.
偏执恐惧建立在自我负面看法所产生的脆弱感之上。身体意象问题有可能成为脆弱感的强大驱动因素。鉴于精神分裂症患者经常体重增加，他们的身体意象问题很可能会被提出。我们首次检查了当前有被害妄想的患者的身体自尊 - 对外观的自我评价 - 与症状和心理相关性。
115 名患有非情感性精神病性背景下的被害妄想的患者完成了身体意象、自尊、体重指数（BMI）、精神症状和幸福感的评估。身体自尊也在 200 名普通人群个体中进行了评估。
精神病患者的身体自尊水平明显低于非临床对照组（ = 1.2， < 0.001）。在患者中，女性的身体自尊低于男性，超重或肥胖 BMI 类别低于正常体重范围。身体意象问题与更高水平的抑郁（ = 0.55， < 0.001）、消极的自我信念（-0.52， < 0.001）、偏执（-0.25， = 0.006）和幻觉（-0.21， = 0.025）相关。身体意象问题与较低的心理幸福感（0.41， < 0.001）、积极的自我信念（0.40， < 0.001）、生活质量（0.23， = 0.015）和整体健康（0.31， = 0.001）相关。
目前有被害妄想的患者自尊心较低。身体意象问题与较差的身心健康有关，包括更严重的精神病体验。改善精神分裂症患者的身体意象是一种可行的干预目标，可能会带来广泛的益处。
