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精神分裂症和情感性精神病患者语言与思维障碍的临床评估

Clinical evaluation of language and thought disorders in patients with schizophrenic and affective psychoses.

作者信息

Küfferle B, Lenz G, Schanda H

出版信息

Psychopathology. 1985;18(2-3):126-32. doi: 10.1159/000284225.

Abstract

56 patients with RDC diagnoses of schizophrenia (n = 40) and mania (n = 16) were interviewed with a structured interviewing procedure. The evaluation was performed by 2 raters who were blind for diagnosis. Two instruments were used for evaluation concerning thought and language disorders: the 'Scale for Assessment of Thought, Language and Communication' developed by Andreasen and the 'Endogenomorphic Schizophrenic Axial Syndrome' by Berner with its emphasis on thought disorders. The interrater reliability for both instruments was found to be good to acceptable for the essential items. A comparison of the frequency of thought disorders according to the two different instruments showed an occurrence of derailment and incoherence of the Andreasen scale in both diagnostic groups, while thought disorders of the schizophrenic axial syndrome were represented only in the group of schizophrenics. This is because in contrast to the Andreasen scale, the presence of pressure of speech is considered as an exclusion criterion for the schizophrenic axial syndrome. Thus, thought disorders according to the schizophrenic axial syndrome are seen to possess diagnostic significance.

摘要

对56例经研究诊断标准(RDC)诊断为精神分裂症(n = 40)和躁狂症(n = 16)的患者采用结构化访谈程序进行访谈。评估由两名对诊断不知情的评估者进行。使用两种工具评估思维和语言障碍:一种是由安德里亚森编制的“思维、语言和沟通评估量表”,另一种是由伯纳编制的强调思维障碍的“内源性精神分裂症轴性综合征”。发现这两种工具对于关键项目的评估者间信度良好至可接受。根据这两种不同工具对思维障碍频率进行的比较显示,在两个诊断组中,安德里亚森量表均出现了思维脱逸和思维不连贯,而精神分裂症轴性综合征的思维障碍仅出现在精神分裂症患者组中。这是因为与安德里亚森量表不同,言语逼迫感的存在被视为精神分裂症轴性综合征的排除标准。因此,精神分裂症轴性综合征的思维障碍具有诊断意义。

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