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种族与精神分裂症症状的报告

Ethnicity and reporting of schizophrenic symptoms.

作者信息

Randolph E T, Escobar J I, Paz D H, Forsythe A B

出版信息

J Nerv Ment Dis. 1985 Jun;173(6):332-40. doi: 10.1097/00005053-198506000-00002.

Abstract

Eighty-one clinically diagnosed (DSM-III) Hispanic and Anglo schizophrenic subjects were evaluated with a structured diagnostic interview, the National Institute of Mental Health Diagnostic Interview Schedule (NIMH-DIS), and a battery of rating instruments (Brief Psychiatric Rating Scale, Clinical Global Impressions, Global Assessment Scale, and Hopkins Symptom Checklist 90 [SCL-90]). The authors examined: a) consistency in reporting of symptoms across different instruments administered in different formats and b) the importance of ethnic background in consistency of responses to the different instruments. A subgroup of patients (23% of total) "denied" lifetime schizophrenic symptoms in the lay interviewer-administered structured interview ("DIS negative" schizophrenic subjects). The proportion of DIS negative subjects was very similar across the two ethnic groups. However, responses by DIS negative schizophrenic subjects to a self-rating instrument (SCL-90) were significantly different for Hispanic and Anglo subjects. A subgroup of Anglo subjects denied symptoms in the DIS, but volunteered them in the self-rating instrument. Responses of Hispanic subjects were consistent regardless of format.

摘要

81名经临床诊断(依据《精神疾病诊断与统计手册》第三版[DSM-III])的西班牙裔和英裔精神分裂症患者接受了结构化诊断访谈、美国国立精神卫生研究所诊断访谈表(NIMH-DIS)以及一系列评定工具(简明精神病评定量表、临床总体印象量表、总体评估量表和霍普金斯症状清单90[SCL-90])的评估。作者考察了:a)以不同形式使用的不同工具在症状报告方面的一致性,以及b)种族背景在对不同工具反应一致性方面的重要性。一部分患者(占总数的23%)在由外行人进行访谈的结构化访谈中“否认”有终生精神分裂症症状(“DIS阴性”精神分裂症患者)。两个种族中DIS阴性患者的比例非常相似。然而,DIS阴性精神分裂症患者对自评工具(SCL-90)的反应在西班牙裔和英裔患者中存在显著差异。一部分英裔患者在DIS中否认有症状,但在自评工具中主动说出了这些症状。西班牙裔患者的反应无论形式如何都是一致的。

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