Datta Arnab, Chetia Dhrubajyoti
Department of Psychiatry, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, India.
Indian J Psychiatry. 2023 Mar;65(3):361-367. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_238_22. Epub 2023 Mar 3.
Resilience is the capacity to bounce back from adversity. Severe mental illnesses are associated with poor and heterogeneous functional outcomes. Symptom remission is inadequate to achieve patient-oriented outcome, and positive psychopathology constructs like resilience have emerged as possible mediators. An exploration of resilience and its association with functional outcomes can drive therapeutic endeavors.
To assess and compare the influence of resilience on disability among patients diagnosed and treated for bipolar disorder and schizophrenia in a tertiary care facility.
Study design - Hospital-based, cross-sectional, comparative design; study population - patients of bipolar disorder and schizophrenia with 2-5 years illness and Clinical Global Impression - Severity (CGI-S) <4; sampling procedure - consecutive sampling; sample size - 30 patients each; scales used - Connor-Davidson Resilience Scale (CD-RISC), Indian Disability Evaluation and Assessment Scale (IDEAS), and CGI-S; patients were evaluated with IDEAS, and 15 persons with and without a significant disability were recruited in each group of schizophrenia and bipolar disorder.
The mean CD-RISC 25 score for persons with schizophrenia was 73.60 ± 13.87, whereas that for persons with bipolar disorder was 78.10 ± 15.26. For schizophrenia, only CDRISC-25 scores are statistically significant ( = -2.582, = 0.018) for predicting IDEAS global disability. For bipolar disorder, CDRISC-25 scores ( = -2.977, = 0.008) and CGI-severity scores ( = 3.135, = 0.005) are statistically significant for predicting IDEAS global disability.
When disability is factored in, resilience is comparable in persons with schizophrenia and bipolar disorder. Resilience independently predicts disability in both groups. However, the type of disorder does not significantly affect the relationship between resilience and disability. Irrespective of diagnosis, higher resilience is associated with lower disability.
心理韧性是指从逆境中恢复的能力。严重精神疾病与功能预后不良且具有异质性相关。症状缓解不足以实现以患者为导向的预后，而像心理韧性这样的积极精神病理学构念已成为可能的调节因素。对心理韧性及其与功能预后的关联进行探索可以推动治疗工作。
评估并比较心理韧性对三级医疗设施中诊断和治疗的双相情感障碍和精神分裂症患者残疾情况的影响。
研究设计——基于医院的横断面比较设计；研究人群——患有双相情感障碍和精神分裂症且病程为2至5年、临床总体印象-严重程度（CGI-S）<4的患者；抽样程序——连续抽样；样本量——每组30例患者；使用的量表——康纳-戴维森心理韧性量表（CD-RISC）、印度残疾评估量表（IDEAS）和CGI-S；患者接受IDEAS评估，精神分裂症和双相情感障碍每组分别招募15名有或无显著残疾的患者。
精神分裂症患者的CD-RISC 25平均得分为73.60±13.87，而双相情感障碍患者为78.10±15.26。对于精神分裂症，只有CDRISC-25得分在预测IDEAS总体残疾方面具有统计学意义（=-2.582，=0.018）。对于双相情感障碍，CDRISC-25得分（=-2.977，=0.008）和CGI-严重程度得分（=3.135，=0.005）在预测IDEAS总体残疾方面具有统计学意义。
将残疾因素考虑在内时，精神分裂症患者和双相情感障碍患者的心理韧性相当。心理韧性在两组中均能独立预测残疾情况。然而，疾病类型对心理韧性与残疾之间的关系没有显著影响。无论诊断如何，心理韧性越高，残疾程度越低。
