Chang Ming-Jyun, Huang Si-Sheng
Department of Medical Education, Changhua Christian Hospital, Division of General Practice (PGY), Changhua, Taiwan, Republic of China.
Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan, Republic of China.
Psychiatry Clin Psychopharmacol. 2023 Dec 1;33(4):292-298. doi: 10.5152/pcp.2023.23668. eCollection 2023 Dec.
Studies comparing insight toward illness in patients with bipolar I disorder manic episode and in patients with major depressive disorder are scarce. The aim of this study was to investigate the attitudes and insight of patients with bipolar I disorder in manic episode and in patients with major depressive disorder.
In total, 86 patients were recruited, including 52 inpatients with bipolar I disorder in manic episodes and 34 inpatients with major depressive disorder. Attitudes toward illness were evaluated using the Self-Appraisal of Illness Questionnaire. Higher Self-Appraisal of Illness Questionnaire scores indicate better awareness and positive attitudes toward one's illness. Insights were assessed using the Insight Scale for Affective Disorders. Higher scores indicate poorer insight. To identify group differences, we used Mann-Whitney test for statistical analysis.
In the Self-Appraisal of Illness Questionnaire, items 1, 2, 3, 4, 6, 7, 10, 15, and 17 showed significantly lower scores in patients with bipolar I disorder than those with major depressive disorder (05). All 3 subscales (presence/outcome of illness, need for treatment, and worry) of the Self-Appraisal of Illness Questionnaire revealed significantly lower scores in the bipolar I disorder group ( < .05). In the Insight Scale for Affective Disorders, items 3, 4, 12, and 16 showed significantly higher scores in the bipolar I disorder group (05).
Patients with major depressive disorder had significantly more positive attitudes and greater insight than those with bipolar I disorder. Patients with bipolar I disorder are less aware of their symptoms, including changes in mood, speed of mental functioning, and social relationships. The clinicians may integrate the findings into treatment plans for mood disorders.
比较双相 I 型障碍躁狂发作患者和重度抑郁症患者对疾病洞察力的研究较少。本研究的目的是调查双相 I 型障碍躁狂发作患者和重度抑郁症患者的态度及洞察力。
共招募了 86 名患者，其中包括 52 名双相 I 型障碍躁狂发作的住院患者和 34 名重度抑郁症住院患者。使用疾病自我评估问卷评估对疾病的态度。疾病自我评估问卷得分越高表明对自身疾病的认识越好且态度越积极。使用情感障碍洞察力量表评估洞察力。得分越高表明洞察力越差。为确定组间差异，我们使用 Mann-Whitney 检验进行统计分析。
在疾病自我评估问卷中，双相 I 型障碍患者在第 1、2、3、4、6、7、10、15 和 17 项上的得分显著低于重度抑郁症患者（P<0.05）。疾病自我评估问卷的所有 3 个分量表（疾病的存在/结果、治疗需求和担忧）在双相 I 型障碍组中的得分均显著较低（P<0.05）。在情感障碍洞察力量表中，双相 I 型障碍组在第 3、4、12 和 16 项上的得分显著更高（P<0.05）。
重度抑郁症患者比双相 I 型障碍患者具有显著更积极的态度和更强的洞察力。双相 I 型障碍患者对自身症状的认识较差，包括情绪变化、心理功能速度和社会关系方面。临床医生可将这些发现纳入情绪障碍的治疗计划中。
