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理解与管理精神分裂症患者的认知扭曲

Understanding and Managing Cognitive Distortions in Individuals With Schizophrenia.

作者信息

Verma Kamal K

机构信息

Psychiatry, K. D. (Kanti Devi) Medical College, Hospital & Research Center, Mathura, IND.

出版信息

Cureus. 2023 Sep 14;15(9):e45268. doi: 10.7759/cureus.45268. eCollection 2023 Sep.

Abstract

INTRODUCTION

Schizophrenia is characterized by psychotic symptoms such as delusions, hallucinations, and disorganized thinking and speech. Patients suffering from schizophrenia incited by these delusions react violently in response to real or imagined threats; this engages them in violent behaviours and thus poses a threat. Sparse data are available for patients from India with regard to schizophrenia patients acting on their delusions. The aim of this study was to assess the prevalence of delusional action in patients suffering from schizophrenia and to identify the phenomenological characteristics of those delusions which are associated with action.

MATERIAL METHODS

This study was conducted on patients with a diagnosis of schizophrenia admitted to the indoor patient department (IPD) of the Department of Psychiatry, K.D. Medical College, Hospital & Research Centre, Mathura, India, during the period of February 2022 to July 2022. A semi-structured, semi-open-ended questionnaire was used for interviewing patients regarding demographics, the course of illness, past medical illness, the family history of psychiatric disturbances, and substance use. The study tool used for delusion was the Maudsley Assessment of Delusions Schedule (MADS).

RESULTS

Out of 56 selected subjects, 34 acted on delusion and out of these, 19 were male and 15 female. In our study gender did not play any significant role in acting on delusion. Literacy and nuclear living households played a significant role in influencing delusion-driven behaviours, while the distinction between urban and rural living, though noteworthy, fell just short of achieving statistical significance. An emotional state like anger was significantly important to the patient's acting on delusion, which led to violent behaviour or self-harm.

CONCLUSION

Positive responses are more likely to be associated with leading action on delusion as compared to negative responses, which were also associated with action on delusion; for example, anger was significantly important in the patient's acting on delusion, which led to violent behaviour or self-harm.

摘要

引言

精神分裂症的特征是出现妄想、幻觉以及思维和言语紊乱等精神病性症状。受这些妄想驱使的精神分裂症患者会对真实或想象中的威胁做出暴力反应;这使他们卷入暴力行为,从而构成威胁。关于印度精神分裂症患者依据妄想行事的数据稀少。本研究的目的是评估精神分裂症患者中妄想行为的患病率,并确定与行为相关的那些妄想的现象学特征。

材料与方法

本研究针对2022年2月至2022年7月期间在印度马图拉市K.D.医学院医院及研究中心精神病科住院部(IPD)确诊为精神分裂症的患者进行。使用半结构化、半开放式问卷对患者进行访谈,内容涉及人口统计学、病程、既往病史、精神障碍家族史以及物质使用情况。用于评估妄想的研究工具是莫兹利妄想评定量表(MADS)。

结果

在56名选定的受试者中,34人依据妄想行事,其中19名男性,15名女性。在我们的研究中,性别在依据妄想行事方面未发挥任何显著作用。识字水平和核心家庭生活方式在影响受妄想驱动的行为方面发挥了重要作用,而城乡居住差异虽然值得注意,但未达到统计学意义。愤怒等情绪状态对患者依据妄想行事具有显著重要性,这会导致暴力行为或自我伤害。

结论

与消极反应相比,积极反应更有可能与依据妄想采取的主导行为相关,消极反应也与依据妄想的行为相关;例如,愤怒在患者依据妄想行事方面具有显著重要性,这会导致暴力行为或自我伤害。

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