Omelchenko M A, Zinkevich A S, Vares A Y
Mental Health Research Center, Moscow, Russia.
Lomonosov Moscow State Univesity, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(12):83-92. doi: 10.17116/jnevro202312312183.
To study the phenomenon of impulsivity, its components and aggression in patients at risk for schizophrenia at the stage of remission after the first depressive episode.
Forty-eight male patients (mean age 19.4±2.9 years) with the first depressive episode (ICD-10 F32.1, F32.2) with attenuated positive, negative and/or disorganized symptoms were examined. According to the severity of impulsivity, the patients were divided into the clinical group (=26) with pathological impulsivity and the comparison group (=27) without it. The control group consisted of 41 mentally healthy young men, students of higher education of 1-3 courses, (mean age 19.7±1.6 years). HDRS, SOPS, SANS, Barratt Impulsiveness Scale (BIS-11) and Buss Perry Aggression Questionnaire (BPAQ) were used. Statistical analysis was carried out using the Statistica 12 software.
The differences between the clinical group and the comparison group were determined by the total score of the subscale of general symptoms of SOPS at admission (53 [41.75; 56] and 45.5 [41.75; 51.25], respectively) (=187.5; =0.037) and at discharge (28 [19; 37] and 25 [17.75; 29.25] points respectively) (=166.5; =0.012), according to the total HDRS score at admission (35 [31; 38] and 29 [26; 34.25]) (=191.0; =0.046). In the clinical group, the motor component of impulsivity and the factor of general impulsivity on the BIS-11 correlated with the severity of aggression on the BPAQ (=0.395, <0.05 and =0.635, <0.05, respectively). Significant differences were revealed in the clinical group depending on the presence of negative symptoms on the corresponding SOPS subscale according to the total BPAQ score (=0.01). Correlation analysis showed numerous connections: positive between the total aggressiveness score and the duration of depression (<0.05), negative between the factors of self-control, consistency, attention, and total scores on the SANS and SOPS (<0.05).
We identify the differences in the structure of impulsivity in patients at risk of developing schizophrenia at the stage of remission after the first depressive state, the comparison group and the control group, as well as the relationship of impulsivity factors with individual clusters of psychopathological disorders.
研究首次抑郁发作缓解期精神分裂症风险患者的冲动现象、其组成部分及攻击性。
对48例首次抑郁发作（ICD - 10 F32.1、F32.2）且伴有阳性、阴性和/或紊乱症状减轻的男性患者（平均年龄19.4±2.9岁）进行检查。根据冲动严重程度，将患者分为有病理冲动的临床组（=26）和无病理冲动的对照组（=27）。对照组由41名心理健康的年轻男性组成，为1 - 3年级高等教育学生（平均年龄19.7±1.6岁）。使用汉密尔顿抑郁量表（HDRS）、阳性和阴性症状量表（SOPS）、阴性症状量表（SANS）、巴拉特冲动量表（BIS - 11）和布斯 - 佩里攻击性问卷（BPAQ）。使用Statistica 12软件进行统计分析。
临床组与对照组在入院时SOPS一般症状子量表总分（分别为53 [41.75；56]和45.5 [41.75；51.25]）（=187.5；=0.037）、出院时（分别为28 [19；37]和25 [17.75；29.25]分）（=166.5；=0.012）以及入院时HDRS总分（35 [31；38]和29 [26；34.25]）（=191.0；=0.046）方面存在差异。在临床组中，BIS - 11上的冲动运动成分和一般冲动因子与BPAQ上的攻击严重程度相关（分别为=0.395，<0.05和=0.635，<0.05）。根据BPAQ总分，临床组在相应SOPS子量表上是否存在阴性症状方面存在显著差异（=0.01）。相关分析显示出众多关联：总攻击分数与抑郁持续时间呈正相关（<0.05），自我控制、一致性、注意力因子与SANS和SOPS总分呈负相关（<0.05）。
我们确定了首次抑郁状态缓解期精神分裂症风险患者、对照组和临床组在冲动结构上的差异，以及冲动因子与精神病理障碍各个集群之间的关系。
