Kitamura T, Okazaki Y, Fujinawa A, Takayanagi I, Kasahara Y
FRCPsych, Department of Sociocultural Environmental Research, National Institute of Mental Health, Ichikawa, Chiba, Japan.
Eur Arch Psychiatry Clin Neurosci. 1998;248(3):130-5. doi: 10.1007/s004060050029.
Current psychopathology classifies schizophrenic positive symptoms into four groups: delusions, hallucinations, formal thought disorder, and catatonic symptoms. The present study explores the factor structure of different positive symptoms to refine this classification. The 35 positive symptoms of 429 psychiatric patients, consecutively admitted to any of 95 mental hospitals, with diagnosis of the ICD-10 F20 schizophrenia, were studied. After excluding those items with a base rate of 10% or less, factor analysis yielded six factors. The first factor was loaded by most of Schneider's first-rank symptoms and two specific auditory hallucinations; the second by all the catatonic symptoms and incoherence; the third by bodily delusions/hallucinations; the fourth by delusions of persecution and reference; the fifth by grandiose and religious delusions; and the sixth by visual and miscellaneous hallucinations. The finding that schizophrenic positive symptoms may have more than four dimensions suggests the need for reclassification of schizophrenic symptoms and for reconsideration of evidence-based diagnostic criteria for the disorder.
妄想、幻觉、形式思维障碍和紧张症症状。本研究探讨不同阳性症状的因素结构，以完善这一分类。对连续入住95家精神病院中的任何一家、诊断为ICD - 10 F20精神分裂症的429例精神病患者的35种阳性症状进行了研究。在排除发生率为10%或更低的项目后，因子分析得出六个因子。第一个因子由大多数施奈德一级症状和两种特定的幻听所负载；第二个因子由所有紧张症症状和语无伦次所负载；第三个因子由躯体妄想/幻觉所负载；第四个因子由被害妄想和关系妄想所负载；第五个因子由夸大妄想和宗教妄想所负载；第六个因子由视幻觉和其他幻觉所负载。精神分裂症阳性症状可能具有四个以上维度这一发现表明，有必要对精神分裂症症状进行重新分类，并重新考虑该疾病基于证据的诊断标准。
