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[偏执型精神分裂症中“自知力与自知力缺失”比例形成的研究]

[Research into the formation of proportions of "insight vs lack of insight" in paranoid schizophrenia].

作者信息

Poprawska I, Jarosz M

机构信息

Katedry i I Kliniki Psychiatrii AM, Lodzi.

出版信息

Psychiatr Pol. 1993 Jul-Aug;27(4):363-72.

PMID:8415997
Abstract

The relevant literature was reviewed, focusing on available evidence which emphasizes common occurrence of lack of insight among the sufferers of schizophrenia. The opinion has long been considered one-sided as it ignores occurrence of partial insight. Therefore, the purpose of this research was to attempt to find out to what extent the patient can afford to have insight and when he or she fails in doing so. A group of 100 paranoid schizophrenics were examined and both "insight and lack of insight" scales were applied. The results negate the hypothesis that insight does not take place in schizophrenia. A quarter of those examined displayed partial insight, with 16% of them showing pronounced insight indicating some awareness of changes in their psychic state due to "some" unidentified pathological factors. Different approaches and hypotheses were taken into consideration that would oscillate between the two extreme attitudes of insight and lack of insight. Contiguity between the examined phenomenon and that of coexistence of logically correct trains of thought with incorrect ones, as it occurs in hypomaniacal states, were indicated. An attempt to explain the so-called McEvoy's riddle was made. Final conclusion: It can be assumed that the interpenetration of the two antithetic trains of thought, where one displays partial lack of insight and the other partial insight, may be particularly characteristic of schizophrenia, more so than lack of insight.

摘要

我们查阅了相关文献,重点关注那些强调精神分裂症患者普遍存在自知力缺失的现有证据。长期以来,这种观点被认为是片面的,因为它忽视了部分自知力的存在。因此,本研究的目的是试图弄清楚患者在何种程度上能够具备自知力,以及何时会出现自知力缺失的情况。我们对一组100名偏执型精神分裂症患者进行了检查,并应用了“自知力与自知力缺失”量表。结果否定了精神分裂症不存在自知力的假设。四分之一的受检者表现出部分自知力,其中16%表现出明显的自知力,表明他们意识到由于“某些”不明病理因素导致的心理状态变化。我们考虑了不同的方法和假设,这些方法和假设在自知力和自知力缺失这两种极端态度之间摇摆。研究表明,所研究的现象与轻躁狂状态下逻辑正确的思维链与错误的思维链并存的现象之间存在连续性。我们试图解释所谓的麦科伊之谜。最终结论:可以假设,两种对立思维链的相互渗透,其中一种表现出部分自知力缺失,另一种表现出部分自知力,可能是精神分裂症的一个特别特征,比自知力缺失更为明显。

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