Vaidya Bhuvana Prakash, Shenoy Sonia, Praharaj Samir Kumar
Department of Psychiatry, Ramaiah Medical College, Bengaluru, Karnataka, India.
Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Indian J Psychiatry. 2024 Sep;66(9):788-795. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_521_24. Epub 2024 Sep 19.
The nature of aberrant salience in schizophrenia, whether it is a state or a trait phenomenon, remains unclear.
To assess and compare aberrant salience in patients with schizophrenia at different stages of the illness and to explore its association with symptom severity and medication use.
A total of 113 subjects were included, comprising 83 patients with schizophrenia divided into three groups: group A (acute drug-free symptomatic stage, n = 23), group B (chronic-medicated symptomatic stage, n = 30), and group C (chronic-medicated asymptomatic stage, n = 30). These were compared with a healthy control group (group D, n = 30). Participants were assessed using the Aberrant Salience Inventory (ASI) and clinical rating scales, including Psychotic Symptom Rating Scales, Scale for Assessment of Positive Symptoms, and Scale for Assessment of Negative Symptoms (SANS).
Significant differences were observed across almost all domains of aberrant salience. The most notable differences were between the symptomatic groups (A, B) and the healthy controls (D). Subgroup analysis showed no significant differences between the acute (A) and chronic groups (B, C), but significant differences were found between the symptomatic (A, B) and asymptomatic (C) groups in several domains and in the total ASI score. A highly significant positive correlation was noted between the total ASI score and the symptom rating scales, except for SANS.
Aberrant salience is significantly elevated in patients with prominent positive symptoms, particularly delusions and hallucinations. It appears comparable to the general population in chronic remitted patients, suggesting that aberrant salience is state-dependent. Medication did not significantly influence aberrant salience as both medicated and nonmedicated symptomatic patients continued to exhibit it. However, medication may contribute to reducing aberrant salience by alleviating positive psychotic symptoms.
精神分裂症中异常显著性的本质，无论是一种状态现象还是特质现象，仍不明确。
评估和比较精神分裂症患者在疾病不同阶段的异常显著性，并探讨其与症状严重程度及药物使用的关联。
共纳入113名受试者，其中83名精神分裂症患者分为三组：A组（急性未用药有症状阶段，n = 23）、B组（慢性用药有症状阶段，n = 30）和C组（慢性用药无症状阶段，n = 30）。将这些患者与健康对照组（D组，n = 30）进行比较。使用异常显著性量表（ASI）和临床评定量表对参与者进行评估，临床评定量表包括精神病症状评定量表、阳性症状评定量表和阴性症状评定量表（SANS）。
在几乎所有异常显著性领域均观察到显著差异。最显著的差异存在于有症状组（A、B）与健康对照组（D）之间。亚组分析显示，急性组（A）与慢性组（B、C）之间无显著差异，但在几个领域以及ASI总分方面，有症状组（A、B）与无症状组（C）之间存在显著差异。除SANS外，ASI总分与症状评定量表之间存在高度显著的正相关。
有明显阳性症状（尤其是妄想和幻觉）的精神分裂症患者，其异常显著性显著升高。在慢性缓解期患者中，其异常显著性似乎与普通人群相当，这表明异常显著性与状态有关。药物治疗并未显著影响异常显著性，因为用药和未用药的有症状患者均持续表现出异常显著性。然而，药物治疗可能通过减轻阳性精神病性症状来降低异常显著性。
